Rapid point of care diagnostic tests for viral and bacterial respiratory tract infections--needs, advances, and future prospects

Alimuddin Zumla; Jaffar A Al-Tawfiq; Virve I Enne; Mike Kidd; Christian Drosten; Judy Breuer; Marcel A Muller; David Hui; Markus Maeurer; Matthew Bates; Peter Mwaba; Rafaat Al-Hakeem; Gregory Gray; Philippe Gautret; Abdullah A Al-Rabeeah; Ziad A Memish; Vanya Gant

doi:10.1016/S1473-3099(14)70827-8

Rapid point of care diagnostic tests for viral and bacterial respiratory tract infections--needs, advances, and future prospects

Lancet Infect Dis. 2014 Nov;14(11):1123-1135. doi: 10.1016/S1473-3099(14)70827-8. Epub 2014 Sep 1.

Authors

Alimuddin Zumla¹, Jaffar A Al-Tawfiq², Virve I Enne³, Mike Kidd⁴, Christian Drosten⁵, Judy Breuer⁶, Marcel A Muller⁵, David Hui⁷, Markus Maeurer⁸, Matthew Bates⁹, Peter Mwaba¹⁰, Rafaat Al-Hakeem¹¹, Gregory Gray¹², Philippe Gautret¹³, Abdullah A Al-Rabeeah¹¹, Ziad A Memish¹⁴, Vanya Gant¹⁵

Affiliations

¹ Division of Infection and Immunity, University College London, London, UK; NIHR Biomedical Research Center, University College London Hospitals, London, UK; Department of Medical Microbiology, University College London Hospitals NHS Foundation Trust, London, UK; Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia; UNZA-UCLMS Research and Training Project, University Teaching Hospital, Lusaka, Zambia. Electronic address: a.zumla@ucl.ac.uk.
² John Hopkins Aramco healthcare, Dahran, Saudi Arabia.
³ Division of Infection and Immunity, University College London, London, UK.
⁴ Division of Infection and Immunity, University College London, London, UK; Department of Medical Microbiology, University College London Hospitals NHS Foundation Trust, London, UK.
⁵ Institute of Virology, University of Bonn Medical Centre, Bonn, Germany.
⁶ Division of Infection and Immunity, University College London, London, UK; NIHR Biomedical Research Center, University College London Hospitals, London, UK; Department of Medical Microbiology, University College London Hospitals NHS Foundation Trust, London, UK.
⁷ Division of Respiratory Medicine and Stanley Ho Center for emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong.
⁸ Therapeutic Immunology, Departments of Laboratory Medicine and Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden.
⁹ Division of Infection and Immunity, University College London, London, UK; UNZA-UCLMS Research and Training Project, University Teaching Hospital, Lusaka, Zambia.
¹⁰ UNZA-UCLMS Research and Training Project, University Teaching Hospital, Lusaka, Zambia.
¹¹ Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
¹² Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
¹³ Assistance Publique Hôpitaux de Marseille, CHU Nord, Pôle Infectieux, Institut Hospitalo-Universitaire Méditerranée Infection & Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), Marseille, France.
¹⁴ Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia; Al-Faisal University, Riyadh, Saudi Arabia.
¹⁵ Department of Medical Microbiology, University College London Hospitals NHS Foundation Trust, London, UK.

Abstract

Respiratory tract infections rank second as causes of adult and paediatric morbidity and mortality worldwide. Respiratory tract infections are caused by many different bacteria (including mycobacteria) and viruses, and rapid detection of pathogens in individual cases is crucial in achieving the best clinical management, public health surveillance, and control outcomes. Further challenges in improving management outcomes for respiratory tract infections exist: rapid identification of drug resistant pathogens; more widespread surveillance of infections, locally and internationally; and global responses to infections with pandemic potential. Developments in genome amplification have led to the discovery of several new respiratory pathogens, and sensitive PCR methods for the diagnostic work-up of these are available. Advances in technology have allowed for development of single and multiplexed PCR techniques that provide rapid detection of respiratory viruses in clinical specimens. Microarray-based multiplexing and nucleic-acid-based deep-sequencing methods allow simultaneous detection of pathogen nucleic acid and multiple antibiotic resistance, providing further hope in revolutionising rapid point of care respiratory tract infection diagnostics.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Bacterial Infections / diagnosis*
Bacterial Infections / microbiology
Humans
Molecular Diagnostic Techniques / methods*
Molecular Diagnostic Techniques / trends*
Point-of-Care Systems / trends*
Respiratory Tract Infections / diagnosis*
Respiratory Tract Infections / microbiology
Respiratory Tract Infections / virology
Virus Diseases / diagnosis*
Virus Diseases / virology