The role for rapid molecular diagnostic tests for infectious diseases in precision medicine
Expert Review of Precision Medicine and Drug Development
Introduction: In an era of increasing antimicrobial resistance among both bacterial and fungal pathogens, the ability to identify infectious microorganisms directly in clinical specimens to guide effective antimicrobial therapy early in the course of disease has become paramount. Molecular diagnostic tests that can detect pathogens in multiple specimen types including blood, sputum, stool, urine or cerebrospinal fluid, can decrease the time to diagnosis often to less than 1 hour and improve both antimicrobial use and associated infection prevention measures. Although molecular tests typically demonstrate high degrees of sensitivity and specificity, their cost and the lack of outcome studies showing their positive impact on patient management can be impediments to uptake in laboratories. Areas covered: Diagnostic tests used to identify a broad range of infectious agents causing respiratory tract infections, sexually transmitted infections, sepsis, as well as tests for biomarkers indicative of infection are reviewed. Data are based on a search of the literature using PubMed. Expert commentary: Rapid molecular diagnostic methods are the standard of care for many sexually transmitted diseases and are used increasingly to identify agents of sepsis. Host response markers to identify the presence of infection and differentiate between bacterial and viral agents will be the next major wave of diagnostic tools. Barriers to implementation of molecular diagnostic tests include siloed hospital budgets and the reluctance of many physicians to switch to rapid technologies that, while often superior to traditional microbiological methods in sensitivity and specificity, have little published outcome data to support their use.
Taylor & Francis
Molecular diagnostics, PCR, tuberculosis, sexually transmitted infections, respiratory tract infections, sepsis, antimicrobial stewardship
Tenover, Fred C., "The role for rapid molecular diagnostic tests for infectious diseases in precision medicine" (2018). Biology Faculty Publications. 339.