Background

Rapid diagnostic tests (RDTs) for infectious diseases, with a turnaround time of less than 2 hours, are promising tools that could improve patient care, antimicrobial stewardship and infection prevention in the emergency department (ED) setting. Numerous RDTs have been developed, although not necessarily for the ED environment. Their successful implementation in the ED relies on their performance and impact on patient management.

Objectives

The aim of this narrative review was to provide an overview of currently available RDTs for infectious diseases in the ED.

Sources

PubMed was searched through August 2019 for available studies on RDTs for infectious diseases. Inclusion criteria included: commercial tests approved by the US Food and Drug Administration (FDA) or Conformité Européenne (CE) in vitro diagnostic devices with data on clinical samples, ability to run on fully automated systems and result delivery within 2 hours.

Content

A nonexhaustive list of representative commercially available FDA- or CE-approved assays was categorized by clinical syndrome: pharyngitis and upper respiratory tract infection, lower respiratory tract infection, gastrointestinal infection, meningitis and encephalitis, fever in returning travellers and sexually transmitted infection, including HIV. The performance of tests was described on the basis of clinical validation studies. Further, their impact on clinical outcomes and anti-infective use was discussed with a focus on ED-based studies.

Implications

Clinicians should be familiar with the distinctive features of each RDT and individual performance characteristics for each target. Their integration into ED work flow should be preplanned considering local constraints of given settings. Additional clinical studies are needed to further evaluate their clinical effectiveness and cost-effectiveness.

中文翻译：

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急诊科对传染病的快速诊断检测

背景

传染病的快速诊断测试（RDT）转换时间少于2小时，是有希望的工具，可以改善急诊室（ED）的患者护理，抗菌素管理和感染预防。已经开发了许多RDT，尽管不一定适用于ED环境。它们在急诊室的成功实施取决于其性能和对患者管理的影响。

目标

这篇叙述性综述的目的是概述急诊室中传染病当前可用的RDT。

资料来源

在2019年8月之前对PubMed进行了搜索，以寻找有关传染病的RDT的可用研究。纳入标准包括：经美国食品药品监督管理局（FDA）或欧洲合格认证委员会（CE）批准的具有临床样本数据的体外诊断设备的商业测试，在全自动系统上运行并在2小时内交付结果的能力。

内容

FDA或CE批准的代表性市售测定的非穷举性清单按临床综合征分类：咽炎和上呼吸道感染，下呼吸道感染，胃肠道感染，脑膜炎和脑炎，回国旅客发烧和包括HIV在内的性传播感染。在临床验证研究的基础上描述了测试的性能。此外，讨论了它们对临床结果和抗感染使用的影响，重点是基于ED的研究。

含义

临床医生应该熟悉每个RDT的独特特征以及每个目标的个人性能特征。应考虑到给定设置的本地限制，预先计划将其集成到ED工作流程中。需要进行其他临床研究以进一步评估其临床有效性和成本效益。