Infektiologische Schnelltests in der Praxis und für zu Hause

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Schnelltests in der Infektiologie Patientennahe labormedizinische Verfahren („point of care testing“; POCT) spielen eine zunehmende Rolle für Entscheidungen im Praxisalltag. Neben den bereits etablierten Verfahren (z. B. Glukose oder Protein im Urin) spielen neuartige Einkassettenverfahren (Rapid diagnostic test – RDT) ebenso wie andere POC-Verfahren eine zunehmende Rolle. Eine zeitnahe und zuverlässige Diagnostik ermöglicht auch in der Infektiologie eine gezielte Therapieentscheidung. Perspektivisch können Testverfahren für Patienten, z. B. HIV-Heimtests, eine bedeutende Rolle spielen. Bei allen Verfahren bleiben technisch bedingte Limitationen der Sensitivität und Spezifität eine Herausforderung ebenso wie die Handhabung des Probenmaterials bezüglich prä- und postanalytischer Anforderungen. Weiterhin müssen alle Testergebnisse durch klinisch erfahrene Ärzte bewertet werden.

Abstract

Bedside laboratory procedures so called „point of care testing – POCT” plays an emerging role in clinical routine practice. While glucose or urine protein screening has been established since a while, newer lateral flow assays (LFID), mostly as rapid diagnostic tests (RDT), play and upcoming role, as well as nucleic amplification based and micro carrier based systems. Hereby an accurate and precise diagnostic allows clinical decisions; in infectious diseases as well as other disciplines in medicine. All test are limited by sensitivity and specifity. Moreover, pre- and post-analytic handling also influences the test results. All results need to be assessed by a trained medical doctor.

Schlüsselwörter

Schnelltests - Infektiologie - POCT

Key words

rapid test - infectious diseases - POCT

• Literatur

• 1 Kozel TR, Burnham-Marusich AR. Point-of-Care Testing for Infectious Diseases: [. . .]. J Clin Microbiol 2017; 55: 2313-2320
• 2 Stefaniuk E, Bosacka K, Wanke-Rytt M. et al. The use of rapid test QuikRead go® Strep A in bacterial pharyngotonsillitis diagnosing and therapeutic decisions. Eur J Clin Microbiol Infect Dis 2017; 36: 1733-1738
• 3 Mathison BA, Pritt BS. Update on Malaria Diagnostics and Test Utilization. J Clin Microbiol 2017; 55: 2009-2017
• 4 Coulibaly JT, N’Gbesso YK, Knopp S. et al. Accuracy of urine circulating cathodic antigen test for the diagnosis of Schistosoma mansoni [. . .]. PLoS Negl Trop Dis 2013; 7: e2109
• 5 Chappuis F, Rijal S, Soto A. et al. A meta-analysis of the diagnostic performance of the direct agglutination test and rK39 dipstick for visceral leishmaniasis. BMJ 2006; 333: 723-730
• 6 Lumbala C, Bessell PR, Lutumba P. et al. Performance of the SD BIOLINE® HAT rapid test in various diagnostic algorithms for gambiense human African trypanosomiasis in the Democratic Republic of the Congo. PLoS ONE 2017; 12: e0180555
• 7 Tucker JD, Bien CH, Peeling RW. Point-of-care testing for STI. Curr Opin Infect Dis 2013; 26: 73-79
• 8 Harding-Esch EM, Nori AV, Hegazi A. et al. Impact of deploying multiple point-of-care tests with a ‘sample first’ approach [. . .]. Sex Transm Infect 2017; 93: 424-429
• 9 Cosentino LA, Danby CS, Rabe LK. et al. Use of Nucleic Acid Amplification Testing for Diagnosis of Extragenital Sexually Transmitted Infections. J Clin Microbiol 2017; 55: 2801-2807
• 10 Poiteau L, Soulier A, Roudot-Thoraval F. et al. Performance of rapid diagnostic tests for the detection of anti-HBs in various patient populations. J Clin Virol 2017; 96: 64-66
• 11 Shivkumar S, Peeling R, Jafari Y. et al. Accuracy of rapid and point-of-care screening tests for hepatitis C: [. . .]. Ann Intern Med 2012; 157: 558-566
• 12 Steingart KR, Schiller I, Horne DJ. et al. Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Syst Rev 2014; 33: CD009593
• 13 Chakravorty S, Simmons AM, Rowneki M. et al. The New Xpert MTB/RIF Ultra: [. . .]. MBio 2017; 8: e00812-e00817
• 14 Lawn SD, Kerkhoff AD, Burton R. et al. Diagnostic accuracy, incremental yield and prognostic value of Determine TB-LAM for routine diagnostic testing for tuberculosis in HIV-infected patients [. . .]. BMC Medicine 2017; 15: 67
• 15 Bruning A, Leeflang M, Vos J. et al. Rapid tests for influenza, respiratory syncytial virus, and other respiratory viruses: [. . .]. Clin Infect Dis 2017; 65: 1026-1032
• 16 Simonnet C, Okandze A, Matheus S. et al. Prospective evaluation of the SD BIOLINE Dengue Duo rapid test during a dengue virus epidemic. Eur J Clin Micro Infect Dis 2017; 496: 504-507
• 17 Prazuck T, Karon S, Gubavu C. et al. A Finger-Stick Whole-Blood HIV Self-Test as an HIV Screening Tool Adapted to the General Public. PLoS ONE 2016; 11: e0146755
• 18 Jaspard M, Le Moal G, Saberan-Roncato M. et al. Finger-stick whole blood HIV-1/-2 home-use tests are more sensitive than oral fluid-based in-home HIV tests. PLoS ONE 2014; 9: e101148
• 19 Marcus U, Gassowski M, Drewes J. HIV risk perception and testing behaviours among men having sex with men (MSM) [. . .]. BMC Public Health 2016; 16: 1111