Kundu Ritabrata
Department of Pediatrics, Institute of Child Health, Kolkata, India.
Indian Pediatr. 2018 Mar 15;55(3):233-237.
Presumptive treatment of infections often results in irrational antimicrobial use resulting in detrimental spread of drug resistance and untoward side effects. A rapid diagnostic test (RDT) is a test that delivers a result earlier than conventional testing methods employed in the past to identify the offending microorganism. RDTs help in early definitive therapy, reduction in hospital stay and cost, and in degree of morbidity and mortality associated with the infection. To select a proper RDT, one should consider how specific and sensitive the test is. Most RDTs gives a qualitative result not quantitative; hence disease severity, monitoring of the disease, prognostication and therapeutic efficacy cannot be assessed. A RDT should be easy to perform, should not require sophisticated machines, and kits should be stable in extremes of temperature. RDTs may be of immense help in remote places where conventional diagnostic facilities are unavailable or lack quality. RDTs hold promise of reasonable diagnostic accuracy if done in a optimal clinical background. They should never be ordered as a shotgun approach to exclude all possible infections but should be used judiciously with appropriate interpretation.
对感染进行经验性治疗往往会导致不合理使用抗菌药物,从而造成耐药性的有害传播和不良副作用。快速诊断检测(RDT)是一种比过去用于识别致病微生物的传统检测方法能更早得出结果的检测。RDT有助于早期明确治疗、缩短住院时间和降低成本,以及降低与感染相关的发病率和死亡率。为选择合适的RDT,应考虑检测的特异性和敏感性如何。大多数RDT给出的是定性结果而非定量结果;因此,无法评估疾病严重程度、疾病监测、预后和治疗效果。RDT应易于操作,不需要复杂的仪器,并且试剂盒应在极端温度下保持稳定。在没有传统诊断设施或传统诊断设施质量欠佳的偏远地区,RDT可能会有极大帮助。如果在最佳临床背景下进行,RDT有望获得合理的诊断准确性。绝不应该将其作为排除所有可能感染的笼统方法来使用,而应该在进行适当解读的情况下谨慎使用。