Multiplex diagnostics, syndromic testing, multiplex PCR, and precision diagnostics are changing how laboratories approach complex clinical questions, particularly when different pathogens can produce similar symptoms. Instead of testing for one suspected pathogen at a time, laboratories can use targeted multiplex approaches to investigate several clinically relevant targets from a single specimen, generating broader diagnostic information while potentially reducing sequential testing and improving workflow efficiency.
What is syndromic testing?
Syndromic testing organizes molecular diagnostics around a clinical syndrome rather than a single suspected pathogen.
A respiratory panel, for example, may include a defined group of viruses and bacteria associated with respiratory disease. Other syndromic approaches can target gastrointestinal infections, central nervous system infections, sexually transmitted infections, bloodstream infections or transplant-related infections.
This approach can simplify the diagnostic pathway by providing information on multiple potential causes from the same specimen.
Published reviews have highlighted several advantages of syndromic panels, including rapid turnaround, broad target coverage, and the ability to simplify testing algorithms. At the same time, they emphasize that these tests should be used within appropriate diagnostic stewardship frameworks because more information does not automatically mean better clinical decisions.
Multiplex PCR: more information from the same sample
At the molecular level, multiplex PCR uses multiple sets of primers and probes to detect different targets within the same reaction.
Multiplex PCR can provide several practical advantages such as more targets investigated from a single specimen, reduced need for sequential testing, better use of limited sample volumes, potentially faster access to differential diagnostic information, and reduced use of reagents and consumables compared with running multiple separate reactions.
However, multiplex PCR also creates technical challenges. Every additional target introduces another set of interactions that the assay developer must control. Primer and probe design, fluorescence channels, reaction conditions, analytical sensitivity and specificity all need to work together.
For laboratories running multiplex PCR assays, instrument flexibility and reliable fluorescence detection are important components of the overall testing workflow. The objective, therefore, is to build a panel in which the targets work together reliably.
The BioQuant-96 real-time PCR detection system from Biosan provides five fluorescence channels and supports 96-well plates, 8-tube strips and individual tubes. Its six-zone independent temperature-control approach is designed to support stable fluorescence quantitative analysis, while the system also offers gradient temperature functions and FAST mode when compatible reagents are used.
Tianlong’s Gentier 96E real-time PCR system supports up to six fluorescence channels and can process up to 96 samples per run, with software supporting functions including absolute and relative quantification, SNP analysis and melting-curve analysis.
Choosing the right approach for your laboratory
Multiplex PCR is not the answer to every diagnostic question. For some applications, a targeted singleplex assay may provide the most appropriate and cost-effective solution. For others, particularly when several pathogens can produce similar symptoms, a well-designed syndromic panel can provide valuable information from a single specimen. The key is matching the technology to the application.
At The Science Support, we provide molecular diagnostic technologies from leading suppliers including Biosan and Tianlong, helping laboratories evaluate the right combination of assays, extraction technologies and real-time PCR platforms for their specific testing needs. View our complete portfolio of integrated solutions here.