title: Rapid point of care diagnostic tests for viral and bacterial respiratory tract infections--needs, advances, and future prospects.
abstract: Respiratory tract infections rank second as causes of adult and paediatric morbidity and mortality worldwide. Respiratory tract infections are caused by many different bacteria (including mycobacteria) and viruses, and rapid detection of pathogens in individual cases is crucial in achieving the best clinical management, public health surveillance, and control outcomes. Further challenges in improving management outcomes for respiratory tract infections exist: rapid identification of drug resistant pathogens; more widespread surveillance of infections, locally and internationally; and global responses to infections with pandemic potential. Developments in genome amplification have led to the discovery of several new respiratory pathogens, and sensitive PCR methods for the diagnostic work-up of these are available. Advances in technology have allowed for development of single and multiplexed PCR techniques that provide rapid detection of respiratory viruses in clinical specimens. Microarray-based multiplexing and nucleic-acid-based deep-sequencing methods allow simultaneous detection of pathogen nucleic acid and multiple antibiotic resistance, providing further hope in revolutionising rapid point of care respiratory tract infection diagnostics.
authors.affiliation: Division of Infection and Immunity, University College London, London, UK; NIHR Biomedical Research Center, University College London Hospitals, London, UK; Department of Medical Microbiology, University College London Hospitals NHS Foundation Trust, London, UK; Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia; UNZA-UCLMS Research and Training Project, University Teaching Hospital, Lusaka, Zambia. Electronic address: a.zumla@ucl.ac.uk.
authors.forename: Alimuddin
authors.initials: A
authors.lastname: Zumla
authors.affiliation: John Hopkins Aramco healthcare, Dahran, Saudi Arabia.
authors.forename: Jaffar A
authors.initials: JA
authors.lastname: Al-Tawfiq
authors.affiliation: Division of Infection and Immunity, University College London, London, UK.
authors.forename: Virve I
authors.initials: VI
authors.lastname: Enne
authors.affiliation: Division of Infection and Immunity, University College London, London, UK; Department of Medical Microbiology, University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Kidd
authors.affiliation: Institute of Virology, University of Bonn Medical Centre, Bonn, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Drosten
authors.affiliation: Division of Infection and Immunity, University College London, London, UK; NIHR Biomedical Research Center, University College London Hospitals, London, UK; Department of Medical Microbiology, University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Judy
authors.initials: J
authors.lastname: Breuer
authors.affiliation: Institute of Virology, University of Bonn Medical Centre, Bonn, Germany.
authors.forename: Marcel A
authors.initials: MA
authors.lastname: Muller
authors.affiliation: Division of Respiratory Medicine and Stanley Ho Center for emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong.
authors.forename: David
authors.initials: D
authors.lastname: Hui
authors.affiliation: Therapeutic Immunology, Departments of Laboratory Medicine and Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Markus
authors.initials: M
authors.lastname: Maeurer
authors.affiliation: Division of Infection and Immunity, University College London, London, UK; UNZA-UCLMS Research and Training Project, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bates
authors.affiliation: UNZA-UCLMS Research and Training Project, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Peter
authors.initials: P
authors.lastname: Mwaba
authors.affiliation: Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Rafaat
authors.initials: R
authors.lastname: Al-Hakeem
authors.affiliation: Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Gray
authors.affiliation: Assistance Publique Hôpitaux de Marseille, CHU Nord, Pôle Infectieux, Institut Hospitalo-Universitaire Méditerranée Infection & Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), Marseille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gautret
authors.affiliation: Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Abdullah A
authors.initials: AA
authors.lastname: Al-Rabeeah
authors.affiliation: Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia; Al-Faisal University, Riyadh, Saudi Arabia.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Memish
authors.affiliation: Department of Medical Microbiology, University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Vanya
authors.initials: V
authors.lastname: Gant
mesh_terms: D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods* / Q000639:trends*; D019095:Point-of-Care Systems / Q000639:trends*; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000382:microbiology / Q000821:virology; D014777:Virus Diseases / Q000175:diagnosis* / Q000821:virology