Department of Pathology, The Medical College of Wisconsin, Milwaukee, WI, USA.
Laboratoire de Bactériologie, Hôpital Bichat-Claude Bernard, AP-HP Nord-Université de Paris, F-75018 Paris, France.
Clin Chem. 2021 Dec 30;68(1):59-68. doi: 10.1093/clinchem/hvab143.
Pneumonia is a common illness, accounting for a staggering amount of worldwide morbidity and mortality. The diagnosis of pneumonia is challenging given the variety of responsible pathogens. Diagnostic testing for bacterial pneumonia has traditionally relied on time-consuming culture-based methods, though recently multiplexed molecular approaches have been described. Multiplexed molecular assays for pneumonia have the potential to provide broad diagnostic information in a rapid timeframe. Much has yet to be learned about these assays regarding analytical performance, potential impact, and optimal implementation strategy.
Herein we provide a summary of what is known and what has yet to be learned about multiplexed molecular pneumonia assays. We provide a comparison of the different commercially available assays and summarize the most current performance data for each. We further describe outcome data and lessons learned from those who have implemented these assays worldwide. Finally, based on the current state of performance and outcome data, we provide informed strategies and considerations for laboratories contemplating implementation.
Multiplexed molecular assays for the diagnosis of pneumonia boast high accuracy though the diagnostic information gained from these assays is inherently different from culture and must be interpreted in cultural context. Despite this, these assays can be powerful and effective diagnostic tools with a potential to positively impact patient care. The extent to which this is realized varies from setting to setting, though is dependent on thoughtful implementation and a focus on delivering clear, rapid, and actionable results that can be interpreted in the appropriate context.
肺炎是一种常见疾病，在全球范围内造成了极高的发病率和死亡率。由于病原体种类繁多，肺炎的诊断极具挑战性。细菌性肺炎的传统诊断检测依赖于耗时的培养方法，但最近已经描述了多重分子方法。多重分子检测方法有可能在短时间内提供广泛的诊断信息。关于这些检测方法的分析性能、潜在影响和最佳实施策略，还有很多需要了解。
本文总结了关于多重分子肺炎检测方法的已知和未知内容。我们比较了不同的商业上可用的检测方法，并总结了每种方法的最新性能数据。我们进一步描述了来自世界各地实施这些检测方法的结果数据和经验教训。最后，根据目前的性能和结果数据，我们为考虑实施的实验室提供了明智的策略和考虑因素。
用于肺炎诊断的多重分子检测方法具有很高的准确性，尽管从这些检测方法中获得的诊断信息与培养方法不同，必须在培养背景下进行解释。尽管如此，这些检测方法仍然是强大而有效的诊断工具，有可能对患者护理产生积极影响。这种效果在不同的环境中有所不同，但取决于深思熟虑的实施以及专注于提供清晰、快速和可操作的结果，并在适当的背景下进行解释。
