Integrated molecular and epidemiological assessment of pediatric viral gastroenteritis using qRT-PCR versus rapid immunochromatographic diagnostics
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Andreea Eliza Zaharia 1 2 3 , Elena-Roxana Matache (Vasilache) 1 2 3 , Cosmin-Răducu Răileanu 1 2 3 , Nicoleta-Maricica Maftei 2 3 4 * , Paula Constantinide 3 5, Mădălina Nicoleta Matei 3 6 , Bucă Beatrice Rozalina 7 , Dana Tutunaru 3 4 8 , Gabriela Gurău 1 2 3
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1 Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, Galati, ROMANIA2 Department of Medical Laboratory, “Sf. Ioan” Emergency Clinical Hospital for Children, Galati, ROMANIA3 Center for Research and Technology Transfer in the Medico-Pharmaceutical Field, “Dunarea de Jos” University of Galati, Galati, ROMANIA4 Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, Galati, ROMANIA5 Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, Galati, ROMANIA6 Department of Dental Medicine, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, Galati, ROMANIA7 “Grigore T. Popa” University of Medicine and Pharmacy, Iași, ROMANIA8 Department of Medical Laboratory, “Sf. Apostol Andrei” Emergency Clinical Hospital, Galati, ROMANIA* Corresponding Author

Abstract

Background: Viral gastroenteritis represents a major cause of pediatric morbidity, being one of the leading acute conditions requiring emergency care or hospitalization. Enteric viruses such as rotavirus, norovirus, adenovirus, astrovirus, and sapovirus are frequently implicated, with prevalence varying by age and season. The objective of this study was to assess the distribution of viral agents in children and to compare the performance of two diagnostic methods: immunochromatographic (ICT) and quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR).
Materials and methods: In a retrospective study, a total of 164 children hospitalized with acute gastroenteritis between February 2023 and March 2025 were investigated using qRT-PCR and ICT methods.
Results: The positivity rate for rotavirus, norovirus and adenovirus was 58.5% by qRT-PCR compared to 25.0% by ICT, with slightly higher rates in urban areas (62/103) and in females (54/73). The most affected age group was 1-3 years, with increased incidence during warm seasons. rotavirus was the predominant pathogen (66 cases by qRT-PCR; 32 by ICT), followed by norovirus (41 cases vs. 11), while viral co-infections accounted for 11% of cases. These findings highlight the importance of rapid and accurate etiological diagnosis for appropriate management, prevention of complications, and reduction of unnecessary antibiotic use.
Conclusions: Our findings demonstrated a higher diagnostic performance of qRT-PCR compared with ICT, particularly for the detection of norovirus and rotavirus. Although rapid ICT tests may serve as an initial diagnostic tool in settings with limited access to molecular testing, qRT-PCR provides more reliable pathogen detection and may improve the accuracy of etiological diagnosis. However, the clinical impact of molecular testing on treatment decisions, antibiotic prescriptions, hospitalization duration, and patient outcomes was not assessed in this study.

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Article Type: Original Article

ELECTRON J GEN MED, Volume 23, Issue 6, December 2026, Article No: em767

https://doi.org/10.29333/ejgm/19949

Publication date: 14 Nov 2026

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