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New and novel rapid diagnostics that are impacting infection prevention and antimicrobial stewardship

Sullivan, Kaede V.a; Dien Bard, Jenniferb

Current Opinion in Infectious Diseases: August 2019 - Volume 32 - Issue 4 - p 356–364
doi: 10.1097/QCO.0000000000000565

Purpose of review The current review summarizes advances in rapid diagnostic testing that impacts infection prevention and antimicrobial stewardship programs.

Recent findings A variety of rapid diagnostic technologies to identify organisms in cultured blood are now available. When coupled with antimicrobial stewardship (ASP), these rapid technologies can optimize antimicrobial utilization and patient outcomes. Two rapid molecular panels that detect organisms related to pneumonia are available and may impact infection prevention surveillance definitions. Three molecular tests are available for the detection of meningitis and encephalitis pathogens. Still, the clinical impact of these broad, multiplexed panels need additional clarification. For Clostridioides difficile infections, ultrasensitive toxin A/B assays may provide enhanced sensitivity and specificity compared with enzyme immunoassay and molecular testing respectively. Finally, the adoption of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI TOF MS) for rapid organism identification is growing. Recent US Food and Drug Administration-clearance of a MALDI TOF MS platform for identification of Nocardia, Mycobacteria, and molds may expedite antimicrobial decisions for infections that traditionally required days to weeks for an identification.

Summary Tests with broad diagnostic scope and swift turnaround time are rapidly entering the market. Many impact infection prevention and ASP programs. Collaboration with the microbiology laboratory is crucial to ensure that new tests successfully optimize patient care.

aDepartment of Pathology and Laboratory Medicine, Temple University Health System, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania

bDepartment of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA

Correspondence to Kaede V. Sullivan, MD, Department of Pathology and Laboratory Medicine, Temple University Hospital, 3401 N. Broad St., Room A2 F329, Philadelphia, PA 19140, USA. E-mail:

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