呼吸道感染病原学诊断年度进展2021

Advances in pathogen diagnosis of respiratory infection diseases in 2021

呼吸道感染是人群的常见和高发疾病,严重时可发展为ARDS。各类病原微生物如细菌、真菌、病毒,均可引起呼吸道感染,快速准确的病原检测是实现呼吸道感染疾病有效诊治的关键,但超过50%的患者未能诊断出明确的致病微生物。近年来,以临床宏基因组学、CRISPR(成簇规律间隔的短回文重复序列)为代表的新型检测技术在病原诊断领域取得了迅速发展,在提高病原检出率的同时,也带来了新的挑战。本文综述了过去1年来呼吸道感染病原诊断领域的进展和成果,为呼吸道感染的病原诊断提供临床视角的思考。

Respiratory tract infections(RTI)are a common and highly prevalent disease in the population,which can develop into acute respiratory distress syndrome(ARDS)in severe cases.A large variety of microorganisms can cause RTI,including bacteria,respiratory viruses,and fungi.The timely and accurate detection of these pathogens is the prerequisites of effective treatment of RTI.However,more than 50%of RTI patients failed to diagnosis of causative agents due to unavailability of qualified samples,antimicrobial treatment prior to sample collection,high variety of respiratory pathogens,and influence of the normal flora in respiratory tract.In recent years,progress on molecular diagnosis,especially the novel approaches such as clinical metagenomics and CRSIPR(Clustered regularly interspaced short palindromic repeats),has not only improved our capacity for RTI pathogen detection but also brought new challenges.In this review,we summed up the advances in RTI pathogen diagnosis in 2021 and discussed the clinical benefits and challenges from novel approaches,which provided a clinical perspective on the development and application of these diagnostic tools in the real world.