High-throughput low-cost nl-qPCR for enteropathogen detection: A proof-of-concept among hospitalized patients in Bangladesh

Background Diarrheal disease is a leading cause of morbidity and mortality globally, especially in low- middle-income countries. High-throughput low-cost approaches to identify etiologic agents are needed guide public health mitigation. Nanoliter-qPCR (nl-qPCR) an attractive alternative more expensive methods yet nascent application without proof-of-concept among hospitalized patients. Methods A census-based study was conducted diarrheal patients admitted at two government hospitals rural Bangladesh during outbreak period. DNA extracted from stool samples assayed by nl-qPCR for common bacterial, protozoan, helminth enteropathogens as the primary outcome. Results total 961 were enrolled; collected 827 Enteropathogens detected 69% patient samples; More than one enteropathogen 32%. most commonly enteroaggregative Escherichia coli (26.0%), Shiga toxin-producing E . (18.3%), enterotoxigenic (15.5% heat stable toxin positive, 2.2% labile positive), Shigella spp. (14.8%), Vibrio cholerae (9.0%). Geospatial analysis revealed that median number pathogens per proportion cases presenting with severe dehydration greatest amongst residing closest hospitals.” Conclusions This demonstrates high-throughput method detection