Revolutions in Infectious Disease Testing disease testing infectiousdisease PCR flateralflow diagnosis diagnostics
Sequencing methodsReferences Infectious diseases still take 14 million lives worldwide each year, making up a quarter of total deaths. This makes them a leading cause of mortality.
Point of care testing A major advance in this field has been the entrance of rapid point of care tests . These comprise rapid diagnostic tests based on direct microscopy or antibody-based antigen recognition methods. These include agglutination, enzyme-linked immunosorbent assays, optical immunoassays, and lateral flow assays based on immunochromatography.
Aptamers binding certain microbial components with high affinity may be substituted for the more heat-fragile antibodies, thus making RDTs more tolerant of tropical climates in future versions. Signal enhancement is another area that requires improvement to boost the sensitivity of these tests at low analyte concentrations. Antibody arrays on one platform are also being considered to enable screening for or diagnosis of any of multiple IDs using a single test.
MALDI-TOF targets the detection of microbial cultures in conditions like urinary sepsis, where culture is both time-consuming and often inaccurate. Based on the detection of ribosomal proteins by mass spectrometry , it is highly regarded for its speed, low cost, and simplicity of operation. It is in use in many European laboratories, though work continues to improve its discrimination of several species.
Isothermal amplification technologies dispense with the need for a thermocycler but are supposed to amplify nucleic acid at least as efficiently as PCR, making them cheaper and less sophisticated. Lab-on-a-chip Microfluidics has enabled the development of lab-on-a-chip devices, integrating molecular amplification, molecular hybridization, and sophisticated optical or electrochemical detection to identify disease biomarkers in a single, inexpensive system, compatible with a hand-held or portable device.
Next-generation sequencing is a high-throughput platform in which sequence reads are generated at a very large scale in a parallel process. It has also revolutionized the sequencing of pathogens, both for individual infections and microbiome analysis. This helps, for instance, to deal with drug resistance or to track potential outbreaks.
Automation of laboratory testing A third front where improvement is required is the introduction of automation to replace direct handling by trained laboratory and medical staff for very complex assays. The advantages are many, including higher reproducibility, a lower chance of error, independence from workforce shortages, higher throughput, and even the conservation of reagents and specimens with the use of microfluidics, in some cases.
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