Recently, the "Expert Consensus on Grading Detection of New and Emerging Respiratory Infectious Pathogens (2024)" organized by the Clinical Microbiology Laboratory Professional Committee of the Chinese Hospital Association and co-authored by Xu Yingchun of Peking Union Medical College Hospital and Wang Jianwei of Peking Union Medical College was published in the "Union Medical Journal". The "Consensus" analyzes the infectiousness and infection characteristics of emerging respiratory pathogens, takes into account the characteristics of the patient population, and develops a three-level detection strategy that includes traditional microbial morphology, immunology, molecular biology, and metagenomic sequencing, and clarifies the recommended detection methods for different pathogens at different stages. The consensus recommends that the respiratory infectious pathogen detection process be divided into three levels. The first level is the common clinical infectious pathogens that cause acute respiratory infections, including influenza A virus, respiratory syncytial virus, etc.; the second level is the infectious pathogens that cause chronic respiratory infections and rare respiratory infectious pathogens, including Mycobacterium tuberculosis, measles virus, etc.; the third level is the new and emerging respiratory infectious pathogens, such as Middle East respiratory syndrome coronavirus, Nipah virus, etc. For acute respiratory infections suspected to be caused by common clinical infectious pathogens, the "Consensus" recommends that bacterial smears and isolation culture, antigens, antibodies, single-target pathogen nucleic acid detection and other technologies should be used as the first choice for testing; for chronic respiratory infections and rare respiratory infectious pathogens, pathogen selective culture or target-specific nucleic acid detection technology is recommended. For patients whose pathogens cannot be identified, pathogen metagenomic sequencing (mNGS) or targeted sequencing (tNGS) technology should be used to further clarify the diagnosis. |
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