TABLE 1

Performance characteristics of diagnostic approaches to respiratory infection

		Respiratory viruses					M. tuberculosis complex
		Sensitivity	Specificity	Time to result^ƒ	User-friendly	Unknown or uncommon viruses	Sensitivity	Specificity	Time saving	User-friendly	Drug susceptibility testing
Molecular diagnosis	Manual NAAT	+++	+++	−	−	−	+++	++	+	−	+
	Automated NAAT	+++	+++	+	+	−	+++	+++	++	++	++
	POCT-NAAT	+	++	+++	+++	−	+++	+++	+++	+	+
	NGS (metagenomics and WGS)	−	−	−	−	++	+	+++	−	−	+++
Microscopy	IFA or ZN/AR^#	−	++	−	−	−	+	+	++	+	−
Culture^¶		−	+	−	−	+	+++	+++	−	−	+++
Antigen Detection	POCT Ag	−	+	+++	++	−	+⁺	++	+++	+++	NA
Antigen Detection	ELISA	++	++	−	−	−	NA	NA	NA	NA	NA
Immunodiagnosis	Serology	NRU	NRU	−	−	−	Not recommended	Not recommended	NRU	NRU	NA
	IFNγ release assays	ES	ES	−	−	−	++	+	++	+	NA
	Skin test^§	NA	NA	NA	NA	NA	++	+	++	++	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.