Rapid diagnostic test for respiratory infections

Abstract

a b s t r a c tAcute respiratory infections are the second cause of morbidity and mortality in children and adults worldwide, being viruses, bacteria and fungi involved in their aetiology. The rapid diagnosis allows for a better clinical management of the patient, for adopting public health measures and for controlling possible outbreaks. The main etiologic agents can be diagnosed within the first hours after the onset of symptoms with antigen detection techniques, primarily immunochromatography. Results are obtained in 15-30 min, with 70-90% sensitivity and >95% specificity for the diagnosis of Streptococcus pneumoniae and Legionella pneumophila serogroup O1 infections from urine, Streptococcus pyogenes from throat swabs and respiratory syncytial virus from nasopharyngeal aspirates. Worse results are obtained for influenza viruses and Pneumocystis jirovecii with these techniques; however, other easy-to-perform molecular techniques are available for the rapid diagnosis of these microorganisms. In general, these techniques should not be used for monitoring the outcome or response to treatment. (J.M. Marimón). 2529-993X/

Viral Respiratory Infections: New Tools for a Rapid Diagnosis

“…Regrettably, their suboptimal sensitivity limits the clinical utility in the viral respiratory infection diagnosis. 30 31 32 33…”

“…Regrettably, their suboptimal sensitivity limits the clinical utility in the viral respiratory infection diagnosis. [30][31][32][33] Currently, commercial RATs availability is limited to the detection of influenza A virus, influenza B virus, RSV, and SARS-CoV-2. 29,34,35 These include latex agglutination tests, horizontal flow devices, lateral flow devices, and optical immunoassay.…”

“…Systems that allow the processing of multiple samples at the same time generally have too long times to be used as rapid tests, while tests that process few samples at a time provide rapid results (<1.5 hours) and can be used as POCT. 33…”

“…Systems that allow the processing of multiple samples at the same time generally have too long times to be used as rapid tests, while tests that process few samples at a time provide rapid results (<1.5 hours) and can be used as POCT. 33 Different studies demonstrate that the faster the diagnosis, the greater the benefits. In a randomized clinical trial including 998 adults with respiratory symptoms admitted in the emergency unit, multiplex PCR results for 496 patients were available in 24 hours (intervention group) and those for the remaining 502 patients were available in 7 days (control group).…”

“…However, due to the number of etiological agents potentially implicated in acute respiratory infections, conventional monoplex PCR assays are tedious, expensive, and require large amounts of biological samples. In recent years, multiplex molecular detection approaches capable of simultaneously detecting the majority of possible viruses involved in clinical respiratory manifestations (12 to 33 different pathogens) 33 have been increasingly developed. 63 This "syndromic approach" is beneficial to set most appropriate treatment decisions in timely manner, to avoid inappropriate use of antibiotics, and to implement correct infection control measures.…”