Respiratory multiplex that matters

 

How can labs use different platforms in developing multiplexing strategies for respiratory disease?

December 11, 2023

 

Summarization of a recent webinar event Roche hosted featuring experts from the University of California-Davis and their health system’s approach to respiratory multiplex testing.

 

What are multiplex tests?

They are parts of syndromic testing that can include very large multi-pathogen panels or targeted panels with two or more pathogens.

Since the pandemic ended and demand for respiratory testing has greatly lessened, many labs have more diversity in platform options than before. This adds new complexity to evaluating the most efficient and effective way to approach respiratory disease testing. And now, more than ever before, there is a range of multiplex and panel tests available that can detect a variety of respiratory diseases.

Nam Tram, Ph.D., and Larissa May, M.D., both of the University of California-Davis, a Roche Diagnostics Center of Excellence, explain how their institution uses the following platforms in a test-to-treat model that includes multiplex testing when appropriate.

Nam Tran, Ph.D., MS, HCLD (ABB), ADLM, is a professor and senior director of clinical pathology at the University of California-Davis Health and director of the Pathology Biorepository and the University of California-Davis Center for Diagnostic Innovation.

Larrissa May, M.D., MSPH, MSHS, is a professor of emergency medicine and director of emergency department innovation and external partnerships at the University of California-Davis and the assistant clinical strategy officer for ventures at UC Davis Health.

With my focus on the emergency department, we want to reduce the unnecessary antibiotic use, which occurs most frequently in the outpatient setting. By volume, 70% to 80% of unnecessary prescriptions are for presumed viral, respiratory-tract infections, so what we want to move toward is a paradigm shift, in which we have more targeted treatment. Of course, the goal is to improve patient outcomes and to reduce adverse events related to excessive antibiotic use, hopefully with a downstream of public health benefit in terms of reducing the acceleration of the emergence of antibiotic-resistant organisms. – Larissa May, M.D.
High throughput, low multiplexed

cobas® 5800 | cobas® 6800 | cobas® 8800

Moderate throughput, highly multiplexed

GenMark® ePlex System

Point-of-care single test, low multiplexed

cobas® liat system

<h3>UC Davis pre-pandemic algorithm</h3><h5>Progression of respiratory testing algorithms over the past few years</h5><p>&nbsp;</p>

UC Davis pre-pandemic algorithm

Progression of respiratory testing algorithms over the past few years

 

UC Davis develops SARS-CoV-2 respiratory approach

The need for Flu A/B and SARS-CoV-2 tests

Supply chains and refined testing capabilities influence approach

More respiratory infections confirm the approach

Back to where UC Davis started

Adult patients with Respiratory Symptoms algorithm chart

What is the future of multiplex testing