Expert Consensus on Nucleic Acid of Amplification Techniques Test for the Diagnosis of Pathogens in Adult Respiratory Tract Infections(2023)

Respiratory tract infection is one of the most prevalent medical conditions. Rapid and accurate diagnosis of pathogens is crucial for precise and effective treatment. However, the sensitivity of traditional microbiological and immunological techniques for respiratory pathogens detection is low.The development and clinical applications of nucleic acid testing technology have dramatically improved the ability to diagnose respiratory pathogens. The rational usage of appropriate nucleic acid testing techniques, based on the underlying diseases, the type of respiratory tract infections, and pathogen spectrum, as well as the correct understanding of its diagnostic sig- nificance, has become an important clinical challenge. Therefore, the Committee of Chinese Laboratory Medical Education and Chinese Thoracic Society initiated a multi-disciplinary Chinese expert consensus. Based on both the domestic and international guidelines and literature, the expert consensus analyzes the clinical application scenarios, technical characteristics, and performance validation requirements pertaining to real-time fluorescence polymerase chain reaction (PCR), isothermal amplification technology, digital PCR, nucleic acid point-of-care testing, and metagenomics next generation sequencing. Furthermore, it also examines the wide-ranging applications of these techniques in diagnosing and managing respiratory tract infections, including acute upper respiratory tract infections, tracheobronchitis, community-acquired pneumonia, hospital-acquired pneumonia/ventilator-associated pneumonia, acute exacerbation of chronic obstructive pulmonary disease, tuberculosis, and respiratory infections in immunocompromised adults. We hope the consensus will provide helpful reference for clinicians.