Age-Stratified Epidemiology of Respiratory Pathogens and the Value of Customizable Syndromic Testing Using the LIAISON PLEX Respiratory Flex Assay.

Publication date: Jun 26, 2025

Molecular syndromic assays have advanced respiratory diagnostics by enabling the simultaneous detection of multiple pathogens from a single sample. However, fixed-panel designs may not align with age-specific prevalence patterns or evolving epidemiological trends, limiting clinical utility and reimbursement viability. In this study, 1,520 positive nasopharyngeal swabs from symptomatic individuals collected during the 2022-2023 respiratory season were analyzed using the LIAISON PLEX Respiratory Flex Assay to evaluate the benefits of customizable, tiered testing strategies. Diagnostic yields from a standard-of-care (SOC) panel were compared with tiered (core-plus-reflex) frameworks across pediatric (65 years) cohorts. Weighted analyses revealed that 99. 8% of cases were viral, while bacterial pathogens accounted for fewer than 1%. The most commonly detected viruses included SARS-CoV-2 (28. 2%), HEV/HRV (17. 1%), Influenza A (11. 9%), and HCoV (7. 4%). Age-related differences were observed, with HEV/HRV and AdV more common in pediatric patients, whereas SARS-CoV-2 and Influenza A predominated in adults and the elderly. SOC panels captured only 58% of infections overall and 33% in pediatric patients, whereas the tiered testing approach identified ≥99% of infections using flexible core-plus-reflex panels. Moreover, core panel targets alone accounted for over 76% of all detections. These findings underscore the diagnostic, clinical, operational, and cost-management value of age-informed, customizable testing frameworks to improve detection, reduce unnecessary testing, and support stewardship.

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Original Article