Microbiology Laboratory: Sample Collection and Diagnosis Advances

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 17177

Special Issue Editors


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Guest Editor
Department of Biology, University of Texas at San Antonio, San Antonio, TX 78249, USA
Interests: biochemistry; pathogen detection; virology; bacteriology; diagnostics; biosensors

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Guest Editor
LuJo BioScience Laboratory, 1747 Citadel Plaza, Suite 201, San Antonio, TX 78209, USA
Interests: sample collection; nucleic acid extraction; qPCR; NGS; sequencing; molecular epidemiology; tuberculosis; influenza; SARS-CoV-2; diagnostics; point of care; rapid detection
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Special Issue Information

Dear Colleagues,

Infectious microbes continue to emerge, causing persistent infections, re-infections, and epidemics worldwide. Advances in the detection of nucleic acids, antigens, and protein assays, as well as the genomic characterization of drug susceptibility markers, have improved microbial diagnosis and treatment. Furthermore, innovations in sample collection, pre-processing, home collection, and point-of-care/decentralized testing have expanded the reach of microbial diagnosis to new patients, populations, and resource-challenged environments. We welcome the submission of manuscripts related to novel advances in the microbial diagnosis of infectious diseases, including but not limited to the fields of virology, bacteriology, mycology, and molecular epidemiology. Acceptable submission types include research articles, short research notes, and reviews.

Prof. Dr. James P. Chambers
Dr. Luke T. Daum
Guest Editors

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Keywords

  • qPCR
  • NGS
  • sample collection
  • nucleic acid testing
  • rapid antigen testing
  • infectious diseases
  • virology
  • sequencing
  • point-of-care
  • diagnostics
  • bacteriology diagnosis
  • diagnostics
  • biosensors

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Published Papers (11 papers)

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Research

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11 pages, 1754 KiB  
Article
Evaluation of the Eazyplex® Candida ID LAMP Assay for the Rapid Diagnosis of Positive Blood Cultures
by Arvid Berlau, Sylvia Stoll, Birgit Edel, Bettina Löffler and Jürgen Rödel
Diagnostics 2024, 14(19), 2125; https://doi.org/10.3390/diagnostics14192125 - 25 Sep 2024
Viewed by 420
Abstract
Rapid molecular assays can be used to identify Candida pathogens directly from positive blood cultures (BCs) in a timely manner compared to standard methods using subcultures. In this study, the eazyplex® Candida ID assay, which is based on loop-mediated amplification (LAMP) [...] Read more.
Rapid molecular assays can be used to identify Candida pathogens directly from positive blood cultures (BCs) in a timely manner compared to standard methods using subcultures. In this study, the eazyplex® Candida ID assay, which is based on loop-mediated amplification (LAMP) and is currently for research use only, was evaluated for the identification of the most common fungal species. A total of 190 BCs were analysed. Sensitivity and specificity were 93.88% and 99.26% for C. albicans, 89.13% and 100% for Nakaseomyces glabratus (N. glabratus), 100% and 100% for Pichia kudravzevii (P. kudriavzevii), 100% and 100% for C. tropicalis, and 100% and 99.44% for C. parapsilosis. Sample preparation took approximately 11 min and positive amplification results were obtained between 8.5 and 19 min. The eazyplex® Candida ID LAMP assay is an easy-to-use diagnostic tool that can optimise the management of patients with candidemia. Full article
(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
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13 pages, 1451 KiB  
Article
Comparison of the Direct Identification and Short-Term Incubation Methods for Positive Blood Cultures via MALDI-TOF Mass Spectrometry
by Shu-Fang Kuo, Tsung-Yu Huang, Chih-Yi Lee and Chen-Hsiang Lee
Diagnostics 2024, 14(15), 1611; https://doi.org/10.3390/diagnostics14151611 - 26 Jul 2024
Viewed by 715
Abstract
Timely pathogen identification in bloodstream infections is crucial for patient care. A comparison is made between positive blood culture (BC) pellets from serum separator tubes using a direct identification (DI) method and colonies on agar plates from a short-term incubation (STI) method with [...] Read more.
Timely pathogen identification in bloodstream infections is crucial for patient care. A comparison is made between positive blood culture (BC) pellets from serum separator tubes using a direct identification (DI) method and colonies on agar plates from a short-term incubation (STI) method with a matrix-assisted laser desorption/ionization Biotyper for the evaluation of 354 monomicrobial BCs. Both the DI and STI methods exhibited similar identification rates for different types of bacteria, except for Gram-positive and anaerobic bacteria. The DI method’s results aligned closely with the STI method’s results for Enterobacterales, glucose-non-fermenting Gram-negative bacilli (GNB), and carbapenem-resistant Enterobacterales. The DI method exhibited high concordance with the conventional method for GNB identification, achieving 88.2 and 87.5% accuracy at the genus and species levels, respectively. Compared with the STI method, the DI method showed a less successful performance for Gram-positive bacterial identification (50.5 vs. 71.3%; p < 0.01). The DI method was useful for anaerobic bacterial identification of slow-growing microorganisms without any need for colony growth, unlike in the STI method (46.7 vs. 13.3%; p = 0.04). However, both methods could not identify yeast in positive BCs. Overall, the DI method provided reliable results for GNB identification, offering many advantages over the STI method by significantly reducing the turnaround time and enabling quicker pathogen identification in positive BCs. Full article
(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
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12 pages, 244 KiB  
Article
Determining Diagnostic Sensitivity: A Comparison of Rose Bengal Test, Coombs Gel Test, ELISA and Bacterial Culture in Brucellosis Diagnosis—Analyzing Clinical Effectiveness in Light of Inflammatory Markers
by Orçun Barkay, Faruk Karakeçili, Umut Devrim Binay and Sümeyye Akyüz
Diagnostics 2024, 14(14), 1546; https://doi.org/10.3390/diagnostics14141546 - 17 Jul 2024
Cited by 1 | Viewed by 831
Abstract
Background: Brucellosis is a zoonotic infectious disease. It is estimated that the number of cases reported today is much less than the actual number. We still have difficulty in diagnosing the disease and its organ involvement. In this sense, new approaches that can [...] Read more.
Background: Brucellosis is a zoonotic infectious disease. It is estimated that the number of cases reported today is much less than the actual number. We still have difficulty in diagnosing the disease and its organ involvement. In this sense, new approaches that can be useful in clinical practice are required, and we aimed to evaluate this situation in our study. Methods: 171 of 213 patients followed in our center between January 2021 and April 2024 were included in the study. A total of 150 patients were included in the study as a control group. Rose Bengal test (RBT), Coombs gel test (CGT), enzyme-linked immunosorbent assay (ELISA), and automated blood culture were used for diagnosing brucellosis. Complete blood count, sedimentation, C-reactive protein, and biochemical parameters were obtained. Inflammation markers such as neutrophil–lymphocyte ratio, platelet–lymphocyte ratio, systemic immune-inflammation index, and systemic inflammation response index were calculated. Results: The most successful results in the diagnosis were ELISA (89.4%), RBT (88.3%), CGT (83%), and blood culture (34.8%). For diagnosing sacroiliitis and spondylodiscitis, instead of resorting to expensive methods like magnetic resonance, a combination of ELISA positivity with elevated acute phase reactants and inflammatory markers could be significantly instructive. Conclusions: Optimizing diagnostic algorithms and exploring novel diagnostic approaches, such as inflammatory markers, hold promise for improving diagnosis and management. Full article
(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
13 pages, 2216 KiB  
Article
The Impact of Laboratory Automation on the Time to Urine Microbiological Results: A Five-Year Retrospective Study
by Antonios Kritikos, Guy Prod’hom, Damien Jacot, Antony Croxatto and Gilbert Greub
Diagnostics 2024, 14(13), 1392; https://doi.org/10.3390/diagnostics14131392 - 29 Jun 2024
Viewed by 912
Abstract
Total laboratory automation (TLA) is a valuable component of microbiology laboratories and a growing number of publications suggest the potential impact of automation in terms of analysis standardization, streaking quality, and the turnaround time (TAT). The aim of this project was to perform [...] Read more.
Total laboratory automation (TLA) is a valuable component of microbiology laboratories and a growing number of publications suggest the potential impact of automation in terms of analysis standardization, streaking quality, and the turnaround time (TAT). The aim of this project was to perform a detailed investigation of the impact of TLA on the workflow of commonly treated specimens such as urine. This is a retrospective observational study comparing two time periods (pre TLA versus post TLA) for urine specimen culture processing. A total of 35,864 urine specimens were plated during the pre-TLA period and 47,283 were plated during the post-TLA period. The median time from streaking to identification decreased from 22.3 h pre TLA to 21.4 h post TLA (p < 0.001), and the median time from streaking to final validation of the report decreased from 24.3 h pre TLA to 23 h post TLA (p < 0.001). Further analysis revealed that the observed differences in TAT were mainly driven by the contaminated and positive samples. Our findings demonstrate that TLA has the potential to decrease turnaround times of samples in a laboratory. Nevertheless, changes in laboratory workflow (such as extended opening hours for plate reading and antibiotic susceptibility testing or decreased incubation times) might further maximize the efficiency of TLA and optimize TATs. Full article
(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
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12 pages, 5696 KiB  
Article
Development of Aptamers for RNase Inactivation in Xtract-Free™ Sample Collection and Transport Medium
by Luke T. Daum, John D. Rodriguez and James P. Chambers
Diagnostics 2024, 14(12), 1207; https://doi.org/10.3390/diagnostics14121207 - 7 Jun 2024
Viewed by 1016
Abstract
There is a significant need to develop new environmentally friendly, extraction-free sample collection mediums that can effectively preserve and protect genetic material for point-of-care and/or self-collection, home-collection, and mail-back testing. Systematic evolution of ligands by exponential enrichment (SELEX) was used to create anti-ribonuclease [...] Read more.
There is a significant need to develop new environmentally friendly, extraction-free sample collection mediums that can effectively preserve and protect genetic material for point-of-care and/or self-collection, home-collection, and mail-back testing. Systematic evolution of ligands by exponential enrichment (SELEX) was used to create anti-ribonuclease (RNase) deoxyribonucleic acid (DNA) aptamers against purified RNase A conjugated to paramagnetic carboxylated beads. Following eight rounds of SELEX carried out under various stringency conditions, e.g., selection using Xtract-Free™ (XF) specimen collection medium and elevated ambient temperature of 28 °C, a panel of five aptamers was chosen following bioinformatic analysis using next-generation sequencing. The efficacy of aptamer inactivation of RNase was assessed by monitoring ribonucleic acid (RNA) integrity via fluorometric and real-time RT-PCR analysis. Inclusion of aptamers in reaction incubations resulted in an 8800- to 11,200-fold reduction in RNase activity, i.e., digestion of viral RNA compared to control. Thus, anti-RNase aptamers integrated into XF collection medium as well as other commercial reagents and kits have great potential for ensuring quality intact RNA for subsequent genomic analyses. Full article
(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
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13 pages, 276 KiB  
Article
Enhancing Surgical Safety: Microbiological Air Control in Operating Theatres at University Medical Centre Maribor
by Lidija Gradisnik, Gorazd Bunc, Janez Ravnik and Tomaz Velnar
Diagnostics 2024, 14(10), 1054; https://doi.org/10.3390/diagnostics14101054 - 19 May 2024
Cited by 1 | Viewed by 1504
Abstract
Background: the aim of the study was to assess microbiological air quality in operating theatres by determining the level of microbiological contamination of the air and critical surfaces using the passive air sampling method and compliance of the operating theatre staff with infection [...] Read more.
Background: the aim of the study was to assess microbiological air quality in operating theatres by determining the level of microbiological contamination of the air and critical surfaces using the passive air sampling method and compliance of the operating theatre staff with infection control measures. Materials and methods: The prospective study was conducted in the surgical block of the University Medical Centre Maribor. For two months continuously, ten operating theatres were assessed for microbial contamination of air and surfaces during quiet and active times of the day. A passive air sampling method with Petri dishes on an agar specially adapted for this purpose (plate count agar) was used. In addition, ten surgical procedures were observed to assess staff compliance with recommended practises. Results: Air samples met microbiological standards in all operating theatres. In both sampling sessions of the day (quiet and active periods), microbial contamination of the air was always within the limit of 10 CFU/m3. The average number of bacterial colonies was zero to two during quiet phases and one to four during active phases. Approximately 60% of the isolates from the operating theatres belonged mainly to the genus Staphylococcus: S. epidermidis (36% of the isolates), S. hominis (17.5%) and S. haemolyticus (5.5%). The rest were identified as Streptococcus anginosus (23%) and Bacillus sp. (18%). Pathogenic bacteria and moulds were not present. In regard to staff compliance with good surgical practise, the former varied by behaviour and function, with non-compliance in pre-operative skin preparation and operating theatre congestion being notable. The cleanliness of the environment was satisfactory. Conclusions: Microbiological air control is extremely important for the safety and success of both surgical and postoperative practises. In spite of good results obtained in the study, further improvements in surgical staff compliance with good surgical practise are essential to reduce surgical site infections. Full article
(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
19 pages, 2538 KiB  
Article
Validation of a New Duplex Real-Time Polymerase Chain Reaction for Chlamydia trachomatis DNA Detection in Ocular Swab Samples
by Joana da Felicidade Ribeiro Favacho, Keren Kariene Leite, Thiago Jacomasso, Aline Burda Farias, Luciano Chaves Franco Filho, Samara Tatielle Monteiro Gomes, Herald Souza dos Reis, Gardene Dourado Mota, Pedro Henrique de Caires Schluga, Walleyd Sami Tassi, Rita de Cássia Pontello Rampazzo, Sheila Kay West, Charlotte Ann Gaydos, Antonio José Ledo Alves da Cunha and Alexandre Dias Tavares Costa
Diagnostics 2024, 14(9), 892; https://doi.org/10.3390/diagnostics14090892 - 25 Apr 2024
Cited by 1 | Viewed by 1528
Abstract
Trachoma is the world-leading infectious cause of preventable blindness and is caused by the bacteria Chlamydia trachomatis. In developing countries, diagnosis is usually based on clinical evaluation. Serological-based tests are cheaper than molecular-based ones, but the latter are more sensitive and specific. [...] Read more.
Trachoma is the world-leading infectious cause of preventable blindness and is caused by the bacteria Chlamydia trachomatis. In developing countries, diagnosis is usually based on clinical evaluation. Serological-based tests are cheaper than molecular-based ones, but the latter are more sensitive and specific. The present study developed a new duplex qPCR which concomitantly detects the C. trachomatis cryptic plasmid and the human 18S rRNA gene, with an LOD95% for C. trachomatis DNA of 13.04 genome equivalents per reaction. The new qPCR was tested using 50 samples from an endemic area and 12 from a non-endemic area that were previously characterized using direct immunofluorescence assay (DFA) and clinical evaluation. Among the 50 endemic samples, 3 were found to be positive by clinical evaluation (6%), 18 were found to be positive by DFA (36%), and 48 were found to be positive by qPCR (96%). Next, the new duplex qPCR was validated using 50 samples previously characterized by qPCR. Validation was carried out on a benchtop instrument (ABI7500) or on a portable point-of-care instrument (Q3-Plus), showing 95% specificity and 100% sensitivity. The ubiquitous presence of C. trachomatis DNA in samples from the endemic region confirms that constant monitoring is of paramount importance for the effective measurement of the elimination of trachoma. The newly developed duplex qPCR presented in this study, along with its validation in a portable qPCR system, constitutes important tools toward achieving this goal. Full article
(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
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13 pages, 1940 KiB  
Article
A Lateral-Flow Device for the Rapid Detection of Scedosporium Species
by Genna E. Davies and Christopher R. Thornton
Diagnostics 2024, 14(8), 847; https://doi.org/10.3390/diagnostics14080847 - 19 Apr 2024
Cited by 2 | Viewed by 1253
Abstract
Scedosporium species are human pathogenic fungi, responsible for chronic, localised, and life-threatening disseminated infections in both immunocompetent and immunocompromised individuals. The diagnosis of Scedosporium infections currently relies on non-specific CT, lengthy and insensitive culture from invasive biopsy, and the time-consuming histopathology of tissue [...] Read more.
Scedosporium species are human pathogenic fungi, responsible for chronic, localised, and life-threatening disseminated infections in both immunocompetent and immunocompromised individuals. The diagnosis of Scedosporium infections currently relies on non-specific CT, lengthy and insensitive culture from invasive biopsy, and the time-consuming histopathology of tissue samples. At present, there are no rapid antigen tests that detect Scedosporium-specific biomarkers. Here, we report the development of a rapid (30 min) and sensitive (pmol/L sensitivity) lateral-flow device (LFD) test, incorporating a Scedosporium-specific IgG1 monoclonal antibody (mAb), HG12, which binds to extracellular polysaccharide (EPS) antigens between ~15 kDa and 250 kDa secreted during the hyphal growth of the pathogens. The test is compatible with human serum and allows for the detection of the Scedosporium species most frequently reported as agents of human disease (Scedosporium apiospermum, Scedosporium aurantiacum, and Scedosporium boydii), with limits of detection (LODs) of the EPS biomarkers in human serum of ~0.81 ng/mL (S. apiospermum), ~0.94 ng/mL (S. aurantiacum), and ~1.95 ng/mL (S. boydii). The Scedosporium-specific LFD (ScedLFD) test therefore provides a potential novel opportunity for the detection of infections caused by different Scedosporium species. Full article
(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
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9 pages, 443 KiB  
Communication
Clinical Evaluation of Xpert Xpress CoV-2/Flu/RSV plus and Alinity m Resp-4-Plex Assay
by Wai-Sing Chan, Kan-Pui Wong, Siu-Kei Yau, Ching-Yan Wong, Tsz-Ching Chan, Jeffrey Hung, Kristi Tsz-Wan Lai, Chin-Pang Leung, Candy Ling-Na Wang, Chun-Hang Au, Thomas Shek-Kong Wan, Edmond Shiu-Kwan Ma and Bone Siu-Fai Tang
Diagnostics 2024, 14(7), 683; https://doi.org/10.3390/diagnostics14070683 - 24 Mar 2024
Cited by 1 | Viewed by 1315
Abstract
The performance of the Xpert Xpress CoV-2/Flu/RSV plus and Alinity m Resp-4-Plex Assays were evaluated using 167 specimens, including 158 human respiratory specimens and 9 external quality assessment program (EQAP) samples. For respiratory specimens, CoV-2/Flu/RSV plus exhibited perfect agreement with the standard-of-care (SOC) [...] Read more.
The performance of the Xpert Xpress CoV-2/Flu/RSV plus and Alinity m Resp-4-Plex Assays were evaluated using 167 specimens, including 158 human respiratory specimens and 9 external quality assessment program (EQAP) samples. For respiratory specimens, CoV-2/Flu/RSV plus exhibited perfect agreement with the standard-of-care (SOC) methods (Cohen’s κ: 1, 100% agreement). The overall positive and negative percent agreement (PPA and NPA) were 100%, with 95% confidence intervals of 96.50 to 100% and 85.70 to 100%, respectively. On the other hand, Resp-4-Plex revealed an almost perfect agreement with the SOC methods (Cohen’s κ: 0.92, 97.71% agreement). The overall PPA and NPA were 100% (95.76 to 100%) and 88.46% (70.20 to 96.82%), respectively. For EQAP samples, the results of CoV-2/Flu/RSV plus (9/9) and Resp-4-Plex (4/4) were concordant with the expected results. The experimental limit of detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was the lowest (25 copies/mL for both methods), and that of the respiratory syncytial virus was the highest (400 copies/mL for CoV-2/Flu/RSV plus and 100 copies/mL for Resp-4-Plex). Threshold cycle (Ct) value correlation showed a large positive linear association between CoV-2/Flu/RSV plus and Resp-4-Plex, with R-squared values of 0.92–0.97, and on average, the Ct values of CoV-2/Flu/RSV plus were higher than that of Resp-4-Plex by 1.86–2.78, except for Flu A1 target (−0.66). To conclude, the performance of both assay was comparable to the SOC methods for both upper and lower respiratory specimens. Implementation of these rapid assay may reinforce the diagnostic capacity for the post-pandemic co-circulation of SARS-CoV-2 and other respiratory viruses. Full article
(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
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11 pages, 1159 KiB  
Article
Evaluation of the Diagnostic Performance of a SARS-CoV-2 and Influenza A/B Combo Rapid Antigen Test in Respiratory Samples
by Harika Öykü Dinç, Nuran Karabulut, Sema Alaçam, Hayriye Kırkoyun Uysal, Ferhat Osman Daşdemir, Mustafa Önel, Yeşim Tuyji Tok, Serhat Sirekbasan, Ali Agacfidan, Nesrin Gareayaghi, Hüseyin Çakan, Önder Yüksel Eryiğit and Bekir Kocazeybek
Diagnostics 2023, 13(5), 972; https://doi.org/10.3390/diagnostics13050972 - 3 Mar 2023
Cited by 9 | Viewed by 5163
Abstract
This study aimed to evaluate the performance characteristics of a rapid antigen test developed to detect SARS-CoV-2 (COVID-19), influenza A virus (IAV), and influenza B virus (IBV) (flu) compared with those of the real-time reverse transcription-polymerase chain reaction (rRT-PCR) method. One hundred SARS-CoV-2, [...] Read more.
This study aimed to evaluate the performance characteristics of a rapid antigen test developed to detect SARS-CoV-2 (COVID-19), influenza A virus (IAV), and influenza B virus (IBV) (flu) compared with those of the real-time reverse transcription-polymerase chain reaction (rRT-PCR) method. One hundred SARS-CoV-2, one hundred IAV, and twenty-four IBV patients whose diagnoses were confirmed by clinical and laboratory methods were included in the patient group. Seventy-six patients, who were negative for all respiratory tract viruses, were included as the control group. The Panbio™ COVID-19/Flu A&B Rapid Panel test kit was used in the assays. The sensitivity values of the kit were 97.5%, 97.9%, and 33.33% for SARS-CoV-2, IAV, and IBV, respectively, in samples with a viral load below 20 Ct values. The sensitivity values of the kit were 16.7%, 36.5%, and 11.11% for SARS-CoV-2, IAV, and IBV, respectively, in samples with a viral load above 20 Ct. The kit’s specificity was 100%. In conclusion, this kit demonstrated high sensitivity to SARS-CoV-2 and IAV for viral loads below 20 Ct values, but the sensitivity values were not compatible with PCR positivity for lower viral loads over 20 Ct values. Rapid antigen tests may be preferred as a routine screening tool in communal environments, especially in symptomatic individuals, when diagnosing SARS-CoV-2, IAV, and IBV with high caution. Full article
(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
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Review

Jump to: Research

28 pages, 515 KiB  
Review
The Role and Value of Professional Rapid Testing of Acute Respiratory Infections (ARIs) in Europe: A Special Focus on the Czech Republic, Poland, and Romania
by Pavel Drevinek, Robert Flisiak, Roxana Nemes, Katya A. Nogales Crespo and Krzysztof Tomasiewicz
Diagnostics 2024, 14(6), 631; https://doi.org/10.3390/diagnostics14060631 - 16 Mar 2024
Viewed by 1518
Abstract
This review aims to explore the role of professional diagnostic rapid testing of acute respiratory infections (ARIs), especially COVID-19 and influenza, ensuring proper disease management and treatment in Europe, and particularly in Czech Republic, Poland, and Romania. The paper was constructed based on [...] Read more.
This review aims to explore the role of professional diagnostic rapid testing of acute respiratory infections (ARIs), especially COVID-19 and influenza, ensuring proper disease management and treatment in Europe, and particularly in Czech Republic, Poland, and Romania. The paper was constructed based on a review of scientific evidence and national and international policies and recommendations, as well as a process of validation by four experts. The development of new testing technologies, treatment options, and increased awareness of the negative multidimensional impact of ARI profiles transformed differential diagnosis into a tangible and desirable reality. This review covers the following topics: (1) the multidimensional impact of ARIs, (2) ARI rapid diagnostic testing platforms and their value, (3) the policy landscape, (4) challenges and barriers to implementation, and (5) a set of recommendations illustrating a path forward. The findings indicate that rapid diagnostic testing, including at the point of care (POC), can have a positive impact on case management, antimicrobial and antibiotic stewardship, epidemiological surveillance, and decision making. Integrating this strategy will require the commitment of governments and the international and academic communities, especially as we identified room for improvement in the access and expansion of POC rapid testing in the focus countries and the inclusion of rapid testing in relevant policies. Full article
(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
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