Advances in diagnostic tools for respiratory tract infections: from tuberculosis to COVID-19 – changing paradigms?

Abstract

Respiratory tract infections (RTI) are one of the commonest reasons for seeking healthcare, but are amongst the most challenging diseases in terms of clinical decision making. Proper and timely diagnosis is critical in order to optimize management and prevent further emergence of antimicrobial resistance by misuse, or overuse of antibiotics. Diagnostic tools for RTI include those involving syndromic and etiological diagnosis: from clinical and radiological features to laboratory methods targeting both pathogen detection and host biomarkers, as well as their combinations in terms of clinical algorithms. They also include tools for predicting severity and monitoring treatment response. Unprecedented milestones have been achieved in the context of the COVID-19 pandemic, involving the most recent applications of diagnostic technologies both at genotypic and phenotypic level, which have changed paradigms in infectious respiratory diseases in terms of why, how and where diagnostics are performed. The aim of this review is to discuss advances in diagnostic tools that impact clinical decision making, surveillance and follow-up of RTI and tuberculosis. If properly harnessed, recent advances in diagnostic technologies, including omics and digital transformation emerge as an unprecedented opportunity to tackle ongoing and future epidemics while handling antimicrobial resistance from a One Health perspective.

Nanopore-based metagenomic sequencing: a diagnostic tool in respiratory tract infection

“…In conclusion, we agree with S tojanovic et al [ 1 ] that diagnostic tools, and particularly pathogen identification, remain at the centre of RTI management and that their improvement is integral to advancing patient care and outcomes. We have highlighted the potential impact of nanopore sequencing as a feasible method of pathogen identification in RTI and we believe it has multiple advantages over traditional culture, particularly time to result (including antibiotic resistance markers).…”

“…We read the recent ERJ Open Research article “Advances in diagnostic tools for respiratory tract infections: from tuberculosis to COVID-19 – changing paradigms?” by S tojanovic et al [ 1 ] with great interest. The article represents a comprehensive review of current best practice in diagnosing respiratory tract infection (RTI), as well as highlighting the future of diagnostic tools in this area.…”

“…Quicker confirmation of the right diagnosis leads to patients receiving the correct treatment earlier in their illness and thus increases the probability of a positive outcome. Within their section on pathogen identification, S tojanovic et al [ 1 ] describe microbiological diagnostics as “critical” in the process of ensuring the correct antimicrobial agent is started as soon as possible to maximise treatment benefit and reduce unnecessary drivers of antimicrobial resistance. We believe that nanopore metagenomic sequencing can have a significant impact as a diagnostic tool in patients with suspected bacterial RTI.…”

Measuring T-Cell Responses against SARS-CoV-2 Is of Utility for Disease and Vaccination Management

“…The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected a total of 552.5 million individuals causing the death of 6.35 million since its appearance in December 2019 [ 1 ]. Considered a pandemic since March 2020 after a large global outbreak, it is a major public health concern, filling ICUs and neglecting the control of other diseases [ 2 , 3 , 4 ]. Whilst most people experience an asymptomatic or a mild SARS-CoV-2 infection, others can present a severe condition usually associated with some specific comorbidities.…”

Tuberculosis in the Russian Federation: Dynamics of the Epidemic Indicators before and after COVID-19 Pandemic

“…At the beginning of the 21st century, tuberculosis continues to be an urgent problem which is addressed at different levels. Being one of the main mortality factors in the world, tuberculosis (TB) is still a marker of a country’s social and economic wellbeing [ 1 , 2 ].…”