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Microorganisms
Volume 14
Issue 7
10.3390/microorganisms14071450
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Diagnosis of Respiratory Infections Using Syndromic Panels: A Ct-Based Approach Beyond Qualitative Detection

by
Maria Antonella Zingaropoli
1,*,
Gianluca Bruno Tassone
2,
Eleonora Coratti
2,
Donatella Maria Rodio
1,
Martina Bernassola
1,
Roberta Campagna
2,
Lucilla Caivano
2,
Francesca Pulcinelli
3,
Fabio Midulla
3,
Gioacchino Galardo
4,
Alessandra Pierangeli
5,
Guido Antonelli
2 and
Ombretta Turriziani
2
1
Microbiology and Virology Unit, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy
2
Department of Molecular Medicine, Sapienza University of Rome, 00141 Rome, Italy
3
Department of Pediatrics and Infantile Neuropsychiatry, Sapienza University of Rome, 00141 Rome, Italy
4
Department of Medical and Cardiovascular Sciences, Sapienza University of Rome, 00141 Rome, Italy
5
Department of Well-being, Health and Environmental Sustainability (BeSSA), Sapienza University of Rome, 02100 Rieti, Italy
*
Author to whom correspondence should be addressed.
Microorganisms 2026, 14(7), 1450; https://doi.org/10.3390/microorganisms14071450
Submission received: 25 April 2026 / Revised: 26 June 2026 / Accepted: 29 June 2026 / Published: 30 June 2026
(This article belongs to the Special Issue Recent Advances in Diagnostic Microbiology)
Review Reports Versions Notes

Abstract

This retrospective study, conducted between September 2023 and October 2025, evaluated age-related pathogen prevalence, seasonal dynamics, and cycle threshold (Ct) values in nasopharyngeal specimens from hospitalized subjects with suspected acute respiratory infections (ARIs) using the multiplex syndromic panel. A median-based Delta Ct was calculated to define pathogen dominance in co-detections. A total of 2479 nasopharyngeal swabs were analyzed and 54.4% tested positive for at least one pathogen. Overall, the positivity rate and co-detections were found to be significantly higher in pediatric group than in the adult one (p < 0.0001 and p < 0.0001, respectively). Semi-quantitative analysis revealed that RSV and flu viruses maintained low Ct values irrespective of co-detection, whereas RV/EV, Adv, and human bocavirus (HBoV) exhibited significantly higher Ct values when co-detected. RV/EV showed higher Ct values versus human metapneumovirus A/B (p = 0.0014), human parainfluenza virus (p = 0.0007), flu virus (p = 0.0084) and RSV (p < 0.0001). Likewise, Adv demonstrated higher Ct values in comparison to RSV (p = 0.0046). Seasonal drivers typically dominate over persistent agents. Integrating semi-quantitative interpretation into syndromic panel reporting could enhance diagnostic stewardship, optimize antimicrobial use, and improve resource allocation in high-pressure clinical settings.
Keywords: pediatric respiratory infection; adult respiratory infection; multiplex PCR; respiratory pathogen; respiratory virus; co-infection; Cycle threshold; diagnostic stewardship pediatric respiratory infection; adult respiratory infection; multiplex PCR; respiratory pathogen; respiratory virus; co-infection; Cycle threshold; diagnostic stewardship

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MDPI and ACS Style

Zingaropoli, M.A.; Tassone, G.B.; Coratti, E.; Rodio, D.M.; Bernassola, M.; Campagna, R.; Caivano, L.; Pulcinelli, F.; Midulla, F.; Galardo, G.; et al. Diagnosis of Respiratory Infections Using Syndromic Panels: A Ct-Based Approach Beyond Qualitative Detection. Microorganisms 2026, 14, 1450. https://doi.org/10.3390/microorganisms14071450

AMA Style

Zingaropoli MA, Tassone GB, Coratti E, Rodio DM, Bernassola M, Campagna R, Caivano L, Pulcinelli F, Midulla F, Galardo G, et al. Diagnosis of Respiratory Infections Using Syndromic Panels: A Ct-Based Approach Beyond Qualitative Detection. Microorganisms. 2026; 14(7):1450. https://doi.org/10.3390/microorganisms14071450

Chicago/Turabian Style

Zingaropoli, Maria Antonella, Gianluca Bruno Tassone, Eleonora Coratti, Donatella Maria Rodio, Martina Bernassola, Roberta Campagna, Lucilla Caivano, Francesca Pulcinelli, Fabio Midulla, Gioacchino Galardo, and et al. 2026. "Diagnosis of Respiratory Infections Using Syndromic Panels: A Ct-Based Approach Beyond Qualitative Detection" Microorganisms 14, no. 7: 1450. https://doi.org/10.3390/microorganisms14071450

APA Style

Zingaropoli, M. A., Tassone, G. B., Coratti, E., Rodio, D. M., Bernassola, M., Campagna, R., Caivano, L., Pulcinelli, F., Midulla, F., Galardo, G., Pierangeli, A., Antonelli, G., & Turriziani, O. (2026). Diagnosis of Respiratory Infections Using Syndromic Panels: A Ct-Based Approach Beyond Qualitative Detection. Microorganisms, 14(7), 1450. https://doi.org/10.3390/microorganisms14071450

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