Routine use of point-of-care tests: usefulness and application in clinical microbiology.
Point-of-care (POC) tests offer potentially substantial benefits for the management of infectious diseases, mainly by shortening the time to result and by making the test available at the bedside or at remote care centres. Commercial POC tests are already widely available for the diagnosis of bacterial and viral infections and for parasitic diseases, including malaria. Infectious diseases specialists and clinical microbiologists should be aware of the indications and limitations of each rapid test, so that they can use them appropriately and correctly interpret their results. The clinical applications and performance of the most relevant and commonly used POC tests are reviewed. Some of these tests exhibit insufficient sensitivity, and should therefore be coupled to confirmatory tests when the results are negative (e.g. Streptococcus pyogenes rapid antigen detection test), whereas the results of others need to be confirmed when positive (e.g. malaria). New molecular-based tests exhibit better sensitivity and specificity than former immunochromatographic assays (e.g. Streptococcus agalactiae detection). In the coming years, further evolution of POC tests may lead to new diagnostic approaches, such as panel testing, targeting not just a single pathogen, but all possible agents suspected in a specific clinical setting. To reach this goal, the development of serology-based and/or molecular-based microarrays/multiplexed tests will be needed. The availability of modern technology and new microfluidic devices will provide clinical microbiologists with the opportunity to be back at the bedside, proposing a large variety of POC tests that will allow quicker diagnosis and improved patient care.
Clerc
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O
Infectious Diseases Service, University Hospital Centre and University of Lausanne, Lausanne, Switzerland.
Greub
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G
D000818:Animals; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003141:Communicable Diseases / Q000175:diagnosis*; D006801:Humans; D010271:Parasites / Q000145:classification / Q000302:isolation & purification; D010274:Parasitology / Q000379:methods*; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity; D014773:Virology / Q000379:methods*; D014780:Viruses / Q000145:classification / Q000302:isolation & purification