Performance characteristics of diagnostic approaches to respiratory infection

Respiratory virusesM. tuberculosis complex
SensitivitySpecificityTime to resultƒUser-friendlyUnknown or uncommon virusesSensitivitySpecificityTime savingUser-friendlyDrug susceptibility testing
Molecular diagnosisManual NAAT+++++++++++++
Automated NAAT++++++++++++++++++++
NGS (metagenomics and WGS)+++++++++
MicroscopyIFA or ZN/AR#+++++++
Antigen DetectionPOCT Ag++++++++++++++++NA
ImmunodiagnosisSerologyNRUNRUNot recommendedNot recommendedNRUNRUNA
IFNγ release assaysESES++++++NA
Skin test§NANANANANA+++++++NA

Abbreviations: NAAT: Nucleic Acid Amplification Tests; POCT: Point of Care Test; NGS: Next Generation Sequencing; WGS: whole genome sequencing; NA: Not applicable; NRU: Not routinely used; ES: Experimental settings only.

#IFA: Immunofluorescence microscopy on respiratory samples to detect the most common viruses; ZN/AR: Ziehl-Neelsen or Auramine/Rhodamine staining to detect acid fast bacilli.

Viral culture are established in several eukaryotic cell lines. Mycobacterial culture in liquid or solid media.

+The only approved POCT Ag for TB detects LAM in urine samples and has been licensed to diagnose TB in HIV-infected patients and to monitor therapy.

§Mantoux test; Quantitation: - very poor;+poor; ++: good; +++: excellent.

ƒConsidering only the time of the procedure: less than 2 h.