Nucleic acid–based testing for noninfluenza viral pathogens in adults with suspected community-acquired pneumonia: An official american thoracic society clinical practice guideline

Charles S. Dela Cruz, Scott E. Evans, Marwan M. Azar, Bin Cao, Kristina Crothers, Robert P. Dickson, Susanne Herold, Seema Jain, Ann L. Jennerich, Ann Madhavan, Mark L. Metersky, Laura C. Myers, Eyal Oren, Marcos I. Restrepo, Makeda Semret, Ajay Sheshadri, Richard G. Wunderink

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: This document provides evidence-based clinical practice guidelines on the diagnostic utility of nucleic acid–based testing of respiratory samples for viral pathogens other than influenza in adults with suspected community-acquired pneumonia (CAP). Methods: A multidisciplinary panel developed a Population–Intervention–Comparison–Outcome question, conducted a pragmatic systematic review, and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations. Results: The panel evaluated the literature to develop recommendations regarding whether routine diagnostics should include nucleic acid–based testing of respiratory samples for viral pathogens other than influenza in suspected CAP. The evidence addressing this topic was generally adjudicated to be of very low quality because of risk of bias and imprecision. Furthermore, there was little direct evidence supporting a role for routine nucleic acid–based testing of respiratory samples in improving critical outcomes such as overall survival or antibiotic use patterns. However, on the basis of direct and indirect evidence, recommendations were made for both outpatient and hospitalized patients with suspected CAP. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was not addressed in the literature at the time of the evidence review. Conclusions: The panel formulated and provided their rationale for recommendations on nucleic acid–based diagnostics for viral pathogens other than influenza for patients with suspected CAP.

Original languageEnglish (US)
Pages (from-to)1070-1087
Number of pages18
JournalAmerican journal of respiratory and critical care medicine
Volume203
Issue number9
DOIs
StatePublished - May 1 2021

Keywords

  • Community-acquired pneumonia
  • Pneumonia
  • Viral diagnostics

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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