Marimón José María, Navarro-Marí José María
Microbiology Department, Hospital Universitario Donostia-Instituto de Investigación Sanitaria Biodonostia, San Sebastián, España; Biomedical Research Center Network for Respiratory Diseases (CIBERES), San Sebastián, España.
Servicio de Microbiología, Hospital Virgen de las Nieves, Complejo Hospitales Universitarios de Granada, Granada, España; Instituto Biosanitario Granada.
Enferm Infecc Microbiol Clin. 2017 Feb;35(2):108-115. doi: 10.1016/j.eimc.2016.11.007. Epub 2017 Jan 3.
Acute respiratory infections are the second cause of morbidity and mortality in children and adults worldwide, being viruses, bacteria and fungi involved in their etiology. 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 15-30minutes, 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.
急性呼吸道感染是全球儿童和成人发病和死亡的第二大原因，其病因涉及病毒、细菌和真菌。快速诊断有助于对患者进行更好的临床管理、采取公共卫生措施以及控制可能的疫情爆发。主要病原体可在症状出现后的最初数小时内通过抗原检测技术进行诊断，主要是免疫层析法。对于尿液中肺炎链球菌和嗜肺军团菌血清群O1感染、咽拭子中的化脓性链球菌以及鼻咽抽吸物中的呼吸道合胞病毒的诊断，15至30分钟即可得出结果，灵敏度为70%至90%，特异性大于95%。使用这些技术对流感病毒和耶氏肺孢子菌的检测结果较差；不过，还有其他易于操作的分子技术可用于快速诊断这些微生物。一般来说，这些技术不应被用于监测治疗结果或治疗反应。
