Graf Erin H, Pancholi Preeti
Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, AZ, USA.
Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Curr Infect Dis Rep. 2020 Feb 6;22(2):5. doi: 10.1007/s11908-020-0714-5.
Major technologic advances in two main areas of molecular infectious disease diagnostics have resulted in accelerated adoption or ordering, outpacing implementation, and clinical utility studies. Physicians must understand the limitations to and appropriate utilization of these technologies in order to provide cost-effective and well-informed care for their patients.
Rapid molecular testing and, to a lesser degree, clinical metagenomics are now being routinely used in clinical practice. While these tests allow for a breadth of interrogation not possible with conventional microbiology, they pose new challenges for diagnostic and antimicrobial stewardship programs. This review will summarize the most recent literature on these two categories of technologic advances and discuss the few studies that have looked at utilization and stewardship approaches. This review also highlights the future directions for both of these technologies. The appropriate utilization of rapid molecular testing and clinical metagenomics has not been well established. More studies are needed to assess their prospective impacts on patient management and antimicrobial stewardship efforts as the future state of infectious disease diagnostics will see continued expansion of these technologic advances.
分子感染性疾病诊断两个主要领域的重大技术进步导致其采用或订购加速,超过了实施和临床效用研究的速度。医生必须了解这些技术的局限性及合理应用方法,以便为患者提供具有成本效益且信息充分的治疗。
快速分子检测以及在较小程度上的临床宏基因组学目前已在临床实践中常规使用。虽然这些检测能够进行传统微生物学无法实现的广泛检测,但它们给诊断和抗菌药物管理计划带来了新挑战。本综述将总结有关这两类技术进步的最新文献,并讨论少数关于使用和管理方法的研究。本综述还强调了这两种技术的未来发展方向。快速分子检测和临床宏基因组学的合理应用尚未得到充分确立。随着传染病诊断的未来发展将继续扩大这些技术进步,需要更多研究来评估它们对患者管理和抗菌药物管理工作的预期影响。