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What is Syndromic testing?

In this video Professor Manaf Alqahtani defines syndromic testing and discusses its principles, contextualising it in diagnostic stewardship.
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Hello, everyone. Thank you for joining. My name is Manaf Alqahtani. I’m an associate professor of medicine and microbiology at RCSI in Bahrain. I’m also a consultant in infectious disease and a clinical microbiologist. First, we’re going to start with an introduction to syndromic testing. So let us define, what do we mean by syndromic testing? Basically, it’s the process of using a single test to target multiple pathogens with overlapping signs and symptoms. As you know, a patient, when he comes down to that ER, or to your clinic, he comes in with the signs and symptoms. We wanted to kind of target those signs and symptoms and identify the most likely pathogens that cause the disease itself.
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So it will help the physician in making the diagnosis of many infectious syndromes. However, the diagnostic stewardship, actually, it’s our best hope to maximise the benefit of how to use these syndromic panels. So you’re going to learn more about the right test for the first time for the right patient. In this slide, you are going to see the whole principle of using diagnostic testing or syndromic testing in a way that you can keep the same principle for the antimicrobial stewardship. So you have a patient that comes in to you. You have to do your clinical evaluation. This is where you can apply the diagnostic stewardship.
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So you want to use the right test for the right patient and on the right time. That will give you, actually, the diagnosis. Now, in the diagnosis, you’re going to need some microbiology lab if you’re going to deal with an infectious disease scenario. And then you’re going to have a rapid diagnostic result reported to you. And again, here is where we can apply the antimicrobial stewardship, which is the right interpretation for the right antimicrobial, and giving the right drug at the right time. And finally, you have the definitive diagnosis where you can provide definitive treatment. So what does syndromic approach mean? So it means we get one sample where you can do a comprehensive test in, let’s say, 60 minutes.
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And then you have a report that has a definitive pathogen or pathogens causing the syndromic or causing the disease in the patient. So this, what’s going to lead to better patient management, provide more timely and effective treatment. And it’s going to definitely limit the use of unnecessary antibiotics – and we’re all aware of the cost and the harm of antibiotic abuse – prevent the secondary spread of the infection, and reduce the cause of unnecessary tests. And that’s definitely going to shorten your hospital stay. And that’s what we mean by syndromic approach, just do a single test based on clinical and physical signs that you think what’s going to be the most likely diagnosis.
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It’s going to take a brief length of time where you’re going to have a report that can lead into the definitive diagnosis.

Syndromic testing is the process of using a single test to simultaneously survey a broad range of pathogens which typically cause overlapping signs and symptoms. In this short video, Professor Manaf Alqahtani defines syndromic testing and discusses its principles, contextualising it in diagnostic stewardship.

This approach (the “syndromic approach”) is now used as standard practice in many clinical microbiology laboratories, aiding rapid identification of causative pathogens and quick, effective treatment(s) as a result.

The syndromic approach: one comprehensive syndromic test can be done on one sample (in a short amount of time), producing multiple results in one report. This results in better patient management as there is: more timely and effective treatment, limited use of unnecessary antibiotics, prevention of secondary infection spread, reduced costs of unnecessary tests and shortened hospital stays

What it means to take the syndromic approach to microbiological diagnosis, and the benefits of doing so

If you require a text version of the above image, this is available as a PDF.

As seen in the diagram above, this approach to diagnosis can also limit unnecessary antibiotic consumption and can thus support antimicrobial stewardship (AMS) programmes. Additionally, syndromic testing can also detect the presence of certain bacterial resistance genes. The role of syndromic testing in AMS will be further explored in future steps this week.

The reference cited in the video has been provided as a link in the see also section below.

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Syndromic Testing and Antimicrobial Stewardship

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