title: Point-of-care testing for respiratory viruses in adults: The current landscape and future potential.
abstract: Respiratory viruses are responsible for a large proportion of acute respiratory illness in adults as well as children, and are associated with a huge socio-economic burden worldwide. Development of accurate point-of-care tests (POCT) for respiratory viruses has been listed as a priority by the World Health Organisation and replacing the current paradigm of empirical antimicrobial use with directed use is a listed goal of the movement for reduction in antimicrobial resistance. POCTs for respiratory viruses have previously been limited by the poor sensitivity of antigen detection based tests and by a limited range of detectable viruses. Highly accurate molecular platforms are now able to test for a comprehensive range of viruses, can be operated by non-laboratory staff and can generate a result in approximately 1 h, making them potentially deployable as POCTs. The potential clinical benefits of POC testing for respiratory viruses in adults include a reduction in unnecessary antibiotic use, improved antiviral prescribing for influenza and rationalisation of isolation facilities. We review here the burden of disease, the currently available molecular platforms with potential for POCT use and the existing evidence for clinical and economic benefits of testing for respiratory viruses in adults.
authors.affiliation: NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Brendish
authors.affiliation: Department of Respiratory Medicine, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.
authors.forename: Hannah F
authors.initials: HF
authors.lastname: Schiff
authors.affiliation: Department of Clinical and Experimental Sciences and Respiratory Biomedical Research Unit, University of Southampton, UK. Electronic address: t.w.clark@soton.ac.uk.
authors.forename: Tristan W
authors.initials: TW
authors.lastname: Clark
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017281:Cost of Illness; D004352:Drug Resistance, Microbial; D006801:Humans; D007251:Influenza, Human / Q000175:diagnosis / Q000821:virology; D025202:Molecular Diagnostic Techniques; D000067716:Point-of-Care Testing / Q000191:economics / Q000639:trends; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D014777:Virus Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute respiratory illness; Adults; Antimicrobial resistance; Influenza; Point-of-care testing; Respiratory viruses