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Diagnostic accuracy of a multiplex nucleic acid amplification test for detecting gastrointestinal bacterial pathogens: A multicenter clinical study

In brief

Automated stool PCR showed at least 98.4% negative agreement across bacterial targets

In 1,737 stool specimens, the automated test had at least 98.4% negative agreement for every bacterial target and met positive-agreement benchmarks for Salmonella, Campylobacter and Shiga toxin. Results were less certain or below benchmarks for several less common pathogens, so broader testing is needed to clarify detection performance before labs rely on it across all targets.

Journal
Diagnostic microbiology and infectious disease (Q2)
Published
6 October 2026
Study design
Unclassified
Evidence level
Level 5, Expert Opinion (CEBM 5)
Authors
Ray McMillian, Sonia Paradis, Elizabeth Lockamy, Elizabeth Garrett, April M Bobenchik, Jesse Young, et al.
PMID
42906519
DOI
10.1016/j.diagmicrobio.2026.117687

Why clinicians should know about it

  • Picked for Microbiology (medical) (top studies of the week, 25 October 2026): Multicenter performance evaluation of a multiplex enteric pathogen assay

Abstract

BACKGROUND: Symptoms of many gastrointestinal infections are similar, making it difficult to differentiate the causative agents. Automated PCR-based diagnostic systems can rapidly detect and identify pathogens responsible for these infections. METHODS: BD Enteric Bacterial Panel plus (EBP plus Assay) for BD COR System was assessed versus a single comparator (BioFire™ FilmArray™ GI Panel) or a composite reference (≥2 of 3 assays: BioFire FilmArray GI Panel, BioCode™ GPP, and BD MAX™ EBP/xEBP) for detecting enteric pathogens using patient stool specimens. Positive and negative percent agreement (PPA and NPA) between EBP plus Assay and comparator method(s) were calculated with 95% two-sided confidence intervals (CIs). Agreement ≥90% with CI lower bounds ≥80% was considered acceptable performance. Contrived specimens were included for low prevalence targets. RESULTS: There were 1737 specimens analyzed. NPA met performance thresholds (≥98.4%) for all targets. PPA met performance thresholds for Salmonella spp., Campylobacter spp., and Shiga toxin. Due to low prevalence in the study population, the PPA lower bound of the 95% CI was below the threshold for Shigella spp./enteroinvasive Escherichia coli, Vibrio spp., and Yersinia enterocolitica, while PPA point estimates were not met for Plesiomonas shigelloides and enterotoxigenic E. coli (ETEC). PPA and NPA thresholds were met in contrived specimen testing for Shiga toxin, Vibrio spp., Plesiomonas shigelloides, Yersinia enterocolitica, and ETEC. CONCLUSIONS: The EBP plus Assay implemented on the BD COR System demonstrated good concordance with the comparator method(s) for detecting enteric bacterial pathogens in stool and is suited for high-throughput laboratories seeking to enhance task automation without impacting accuracy.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.