Infectious Disease Diagnostics
10 important questions on Infectious Disease Diagnostics
What are the two types of diagnostic tests?
- Direct detection of (a part of) the agent
- Host-response to (a part of) the agent
How is an infectious agent detected by culture?
What is the principle of nucleic acid amplification?
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What are the pros and cons of nucleic acid amplification?
- There is a high sensitivity
- The risk of contamination is high
- High throughput is possible
- The price per sample does not have to be higher than with cultures
- It is faster than culturing (1-5 hours)
- You need to get the DNA/RNA out of the cell, for this, you need a reagent (of which there was a shortage during the first lockdown)
- You need a specialized lab and specialized personnel
- The nucleic acid might not be infectious
- The specificity is determined by the primers that are used and by the timing
What are the pros and cons of antigen detection tests?
- They can be read by machine or eye
- They are often very rapid
- Mistakes are possible
- They are not so easy to scale up. However, you need less highly skilled personnel
- Less sensitive than NAAT (but NAAT can detect DNA that is not longer active)
What is the principle of antibody detection tests?
What are the pros and cons of antibody detection tests?
- It takes time to develop an immune response (so you don't measure the disease)
- You can also use this method to measure dynamics (which will help you to better understand the timing of an infection)
- The problem with antibodies is that you don't know if it is an active disease or a past disease.
- If people are immunocompromised they might not have a good (or no) response
- With antibodies it is more difficult to predict cross-reactivity
What is meant with the sensitivity of a diagnostic test?
To improve sensitivity and specificity. Multiple tests are commonly combined. What do you know about the needed sensitivity and specificity of the different tests?
What happens to false positives, sensitivity, and specificity if you raise your cut-off?
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