Andrea Palomeque, Catia Cilloniz, Alba Soler-Comas, Joan Canseco-Ribas, Nona Rovira-Ribalta, Anna Motos, Antoni Torres
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Despite improvements in the microbiological diagnosis of CAP in recent decades, the identification of the causative pathogen is often delayed because of difficulties in obtaining good-quality sputum samples, issues in transporting samples, and slow laboratory processes. Therefore, the initial treatment of CAP is usually empirical. Point-of-care testing (POCT) was introduced to avoid treatment delays and reduce reliance on empirical antibiotics.</p><p><strong>Areas covered: </strong>This review summarizes the main scientific evidence on the role of POCT in the diagnosis and management of patients with CAP. The authors searched for articles on POCT in pneumonia on PubMed from inception to 20 January 2024. The references in the identified articles were also searched.</p><p><strong>Expert opinion: </strong>POCT involves rapid diagnostic assays that can be performed at the bedside especially in cases of severe CAP and immunocompromised patients. 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引用次数: 0
摘要
简介社区获得性肺炎(CAP)是全世界死亡率较高的一种传染病。尽管肺炎链球菌仍是 CAP 最常见的病原体,但最近使用分子检测方法进行的研究数据显示,呼吸道病毒在成人肺炎患者中也扮演着重要角色。尽管难治性病原体只占肺炎病例总数的一小部分,但它们对肺炎治疗结果的影响也很重要。尽管近几十年来 CAP 的微生物学诊断有所改进,但由于难以获得高质量的痰液样本、样本运输问题以及实验室流程缓慢等原因,致病病原体的鉴定往往被延误。因此,CAP 的初始治疗通常是经验性的。引入床旁检测(POCT)是为了避免治疗延误,减少对经验性抗生素的依赖:本综述总结了有关 POCT 在 CAP 患者诊断和管理中的作用的主要科学证据。作者在 PubMed 上搜索了从开始到 2024 年 1 月 20 日有关肺炎 POCT 的文章。作者还检索了所发现文章的参考文献:POCT涉及快速诊断测定,可在床边进行,尤其适用于重症CAP和免疫功能低下的患者。这些检测结果有助于指导初始治疗和管理。
A review of the value of point-of-care testing for community-acquired pneumonia.
Introduction: Community-acquired pneumonia (CAP) is an infectious disease associated with high mortality worldwide. Although Streptococcus pneumoniae remains the most frequent pathogen in CAP, data from recent studies using molecular tests have shown that respiratory viruses play a key role in adults with pneumonia. The impact of difficult-to-treat pathogens on the outcomes of pneumonia is also important even though they represent only a small proportion of overall cases. Despite improvements in the microbiological diagnosis of CAP in recent decades, the identification of the causative pathogen is often delayed because of difficulties in obtaining good-quality sputum samples, issues in transporting samples, and slow laboratory processes. Therefore, the initial treatment of CAP is usually empirical. Point-of-care testing (POCT) was introduced to avoid treatment delays and reduce reliance on empirical antibiotics.
Areas covered: This review summarizes the main scientific evidence on the role of POCT in the diagnosis and management of patients with CAP. The authors searched for articles on POCT in pneumonia on PubMed from inception to 20 January 2024. The references in the identified articles were also searched.
Expert opinion: POCT involves rapid diagnostic assays that can be performed at the bedside especially in cases of severe CAP and immunocompromised patients. These tests can produce results that could help guide initial therapy and management.
期刊介绍:
Expert Review of Molecular Diagnostics (ISSN 1473-7159) publishes expert reviews of the latest advancements in the field of molecular diagnostics including the detection and monitoring of the molecular causes of disease that are being translated into groundbreaking diagnostic and prognostic technologies to be used in the clinical diagnostic setting.
Each issue of Expert Review of Molecular Diagnostics contains leading reviews on current and emerging topics relating to molecular diagnostics, subject to a rigorous peer review process; editorials discussing contentious issues in the field; diagnostic profiles featuring independent, expert evaluations of diagnostic tests; meeting reports of recent molecular diagnostics conferences and key paper evaluations featuring assessments of significant, recently published articles from specialists in molecular diagnostic therapy.
Expert Review of Molecular Diagnostics provides the forum for reporting the critical advances being made in this ever-expanding field, as well as the major challenges ahead in their clinical implementation. The journal delivers this information in concise, at-a-glance article formats: invaluable to a time-constrained community.