Table 2.
Select diagnostics for bacterial lower respiratory tract infections (LRTIs).
| Diagnostic | Pathogens | Company | FDA Approved | Sample Type | Time |
|---|---|---|---|---|---|
| Matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) | |||||
| MALDI Biotyper CA; microflex LT/SH MALDI-MS; IVD MALDI Biotyper; MALDI Biotyper smart System; MBT smart CA System [35] | Bacterial, Fungal; 333 species or species groups | Brukner Daltonics | Yes | Induced or expectorated sputum, nasal aspirates or washes, nasopharyngeal (NP) swabs or aspirates, throat washes or swabs, bronchoscopic specimens | Within minutes of analyzing a single colony from isolate |
| Vitek MS [36] | Bacterial, Fungal; 1316 species, includes Brucella, Candida auris, Elizabethkingia anophelis | bio Mérieux | Yes | Induced or expectorated sputum, nasal aspirates or washes, NP swabs or aspirates, throat washes or swabs, bronchoscopic specimens | Within minutes of analyzing a single colony from isolate |
| Nucleic acid amplification tests - Polymerase chain reaction | |||||
| Unyvero A50 System [37] | >30 Gram-positive/Gram-negative bacteria and 10 antibiotic resistance markers or toxins | Curetis AG | Yes | Induced or expectorated sputum, nasal aspirates or washes, NP swabs or aspirates, throat washes or swabs, bronchoscopic specimens | <5 h |
| BIOFIRE FilmArray System Pneumonia Panel plus [38] | 11 Gram-negative, 4 Gram-positive and 3 atypical bacteria, 9 viruses, 7 genetic markers of antibiotic resistance | bio Mérieux | Yes | Induced or expectorated sputum; endotracheal aspirates, bronchoscopic specimens | 1 h |
| Multiplex one-step RT-PCR - FTD Respiratory pathogens 33 [39] | 22 viruses, 11 bacterial pathogens | Fast Track Diagnostics | Yes | Induced or expectorated sputum; endotracheal aspirates, bronchoscopic specimens | <2 h |
| Multiplex ligation-dependent probe amplification - RespiFinder 22 [40] | 18 viruses, 4 bacterial pathogens | PathoFinder | Yes | Induced or expectorated sputum; endotracheal aspirates, bronchoscopic specimens | <2 h |
| VERIGENE Respiratory Pathogens Flex Test [41] | 13 viral and 3 bacterial (Bordetella sp) targets | Nanosphere/Luminex Corporation | Yes | Induced or expectorated sputum; endotracheal aspirates, bronchoscopic specimens | <2 h |
| Serological tests | |||||
| Enzyme immunoassay | Mycoplasma pneumoniae IgG and IgM | Vircell [42]/Zeus [43,44] | Yes | 5 mL serum | <2 h |
| Microimmunofluorescent stain | Chlaymydia pneumoniae | MRL Diagnostics [45]/Labsystems [46] | Yes | 5 mL serum | <2 h |
| Urine antigen tests | |||||
| Enzyme immunoassay - BinaxNOW Legionella Urinary Antigen Card [47] | Legionella pneumophilia (for serogroup 1) | Alere/Abbott | Yes | 10 mL of urine | <1 h |
| Lateral Flow Assay - SAS Legionella [48] | Legionella pneumophilia (for serogroup 1) | SA Scientific | Yes | 10 mL of urine | <1 h |
| Lateral Flow Assay - Bartels Legionella urinary antigen [49] | Legionella pneumophilia (for serogroup 1) | Trinity Biotech | Yes | 10 mL of urine | <1 h |
| Lateral Flow Assay - Meridian Tru Legionella Assay [50] | Legionella pneumophilia (for serogroup 1) | Meridian BioSciences | Yes | 10 mL of urine | <1 h |
| Enzyme immunoassay – BinaxNow Streptococcus pneumoniae Antigen Card [51] | S. pneumoniae | Alere/Abbott | Yes | 10 mL of urine | <1 h |