The University of Groningen, University Medical Centre Groningen, Department of Medical Microbiology and Infection Prevention, Division of Clinical Virology, Groningen, The Netherlands.
J Antimicrob Chemother. 2021 Sep 23;76(Suppl 3):iii58-iii66. doi: 10.1093/jac/dkab243.
Current molecular detection methods for single or multiplex pathogens by real-time PCR generally offer great sensitivity and specificity. However, many infectious pathogens often result in very similar clinical presentations, complicating the test-order for physicians who have to narrow down the causative agent prior to in-house PCR testing. As a consequence, the intuitive response is to start empirical therapy to treat a broad spectrum of possible pathogens. Syndromic molecular testing has been increasingly integrated into routine clinical care, either to provide diagnostic, epidemiological or patient management information. These multiplex panels can be used to screen for predefined infectious disease pathogens simultaneously within a 1 h timeframe, creating opportunities for rapid diagnostics. Conversely, syndromic panels have their own challenges and must be adaptable to the evolving demands of the clinical setting. Firstly, questions have been raised regarding the clinical relevance of some of the targets included in the panels and secondly, there is the added expense of integration into the clinical laboratory. Here, we aim to discuss some of the factors that should be considered before performing syndromic testing rather than traditional low-plex in-house PCR.
目前，通过实时 PCR 对单一或多重病原体进行的分子检测方法通常具有很高的灵敏度和特异性。然而，许多传染性病原体通常会导致非常相似的临床表现，这使得医生在进行内部 PCR 检测之前必须缩小致病因素的范围，从而增加了检测的难度。因此，医生的直观反应是开始进行经验性治疗，以治疗广谱可能的病原体。综合征分子检测已越来越多地整合到常规临床护理中，以提供诊断、流行病学或患者管理信息。这些多重面板可用于在 1 小时内同时筛选预定的传染病病原体，为快速诊断创造机会。相反，综合征面板也有其自身的挑战，必须适应临床环境的不断变化的需求。首先，人们对面板中包含的一些目标的临床相关性提出了质疑；其次，将其集成到临床实验室还会增加额外的费用。在这里，我们旨在讨论在进行综合征检测而不是传统的低多重内部 PCR 之前应考虑的一些因素。
