Calderaro Adriana, Buttrini Mirko, Farina Benedetta, Montecchini Sara, De Conto Flora, Chezzi Carlo
Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy.
Microorganisms. 2022 Sep 16;10(9):1856. doi: 10.3390/microorganisms10091856.
Respiratory tract infections (RTIs) are the focus of developments in public health, given their widespread distribution and the high morbidity and mortality rates reported worldwide. The clinical spectrum ranges from asymptomatic or mild infection to severe or fatal disease. Rapidity is required in diagnostics to provide adequate and prompt management of patients. The current algorithm for the laboratory diagnosis of RTIs relies on multiple approaches including gold-standard conventional methods, among which the traditional culture is the most used, and innovative ones such as molecular methods, mostly used to detect viruses and atypical bacteria. The implementation of molecular methods with syndromic panels has the potential to be a powerful decision-making tool for patient management despite requiring appropriate use of the test in different patient populations. Their use radically reduces time-to-results and increases the detection of clinically relevant pathogens compared to conventional methods. Moreover, if implemented wisely and interpreted cautiously, syndromic panels can improve antimicrobial use and patient outcomes, and optimize laboratory workflow. In this review, a narrative overview of the main etiological, clinical, and epidemiological features of RTI is reported, focusing on the laboratory diagnosis and the potentialities of syndromic panels.
鉴于呼吸道感染（RTIs）在全球范围内广泛传播且报告的发病率和死亡率较高，它们成为了公共卫生发展的重点。临床症状范围从无症状或轻度感染到严重或致命疾病。诊断需要快速进行，以便为患者提供充分和及时的治疗。目前用于RTIs实验室诊断的算法依赖于多种方法，包括金标准传统方法（其中传统培养法使用最为广泛）以及创新方法，如主要用于检测病毒和非典型细菌的分子方法。尽管在不同患者群体中需要适当使用检测方法，但将分子方法与症候群检测相结合有潜力成为一种强大的患者管理决策工具。与传统方法相比，它们的使用从根本上减少了出结果的时间，并增加了对临床相关病原体的检测。此外，如果明智地实施并谨慎解释，症候群检测可以改善抗菌药物的使用和患者预后，并优化实验室工作流程。在本综述中，报告了RTI主要病因、临床和流行病学特征的叙述性概述，重点关注实验室诊断和症候群检测的潜力。
