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多重呼吸道检测的诊断管理:我们已知和需要做的。

Diagnostic Stewardship for Multiplex Respiratory Testing: What We Know and What Needs to Be Done.

机构信息

Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue Northeast, Washington, DC 20037, USA.

Department of Pathology, George Washington University School of Medicine and Health Sciences, 900 23rd Street Northwest, Washington, DC 20037, USA.

出版信息

Clin Lab Med. 2024 Mar;44(1):45-61. doi: 10.1016/j.cll.2023.10.001. Epub 2023 Nov 8.

Abstract

Syndromic respiratory panels are now widely available in clinical microbiology laboratories and health care institutions. These panels can rapidly diagnose infections and detect antimicrobial resistance genes allowing for more rapid therapeutic optimization compared to standard microbiology approaches. However, given reimbursement concerns and limitations of multiplex molecular testing and results interpretation, maximum clinical utility and positive clinical outcomes depend on active diagnostic stewardship. Here, the authors review clinical outcomes of both upper and lower respiratory panels and present diagnostic stewardship strategies for optimal use of respiratory panels.

摘要

症候群相关呼吸检测套组目前在临床微生物学实验室和医疗机构中广泛应用。相较于传统微生物学检测方法,这些套组能够快速诊断感染并检测出抗菌药物耐药基因,从而实现更快的治疗优化。然而,鉴于对报销的关注和多重分子检测的局限性以及结果解读,呼吸道套组的最大临床实用性和积极的临床结果取决于积极的诊断管理。在此,作者回顾了上、下呼吸道套组的临床结果,并提出了诊断管理策略,以优化呼吸道套组的使用。

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