New ADLM Guidance Provides Expert Recommendations on Clinical Testing For Respiratory Viral Infections

By LabMedica International staff writers
Posted on 27 May 2024

Image: The new ADLM guidance will help healthcare professionals navigate respiratory virus testing in a post-COVID world (Photo courtesy of 123RF)

Respiratory tract infections, predominantly caused by viral pathogens, are a common reason for healthcare visits. Accurate and swift diagnosis of these infections is essential for optimal patient management. In light of the COVID-19 pandemic, there have been significant advancements in laboratory medicine, enhancing the testing capabilities for respiratory viruses. These advancements include the use of diverse sample types and the introduction of various new testing methods. However, these developments have also created a need for greater educational efforts on how best to utilize these novel testing options. Addressing this need, a new guidance document has been released, offering expert advice on essential aspects of clinical testing for respiratory viral infections, aiming to maximize the benefits of recent technological advances in this rapidly evolving field.

This guidance has been formed by a multidisciplinary team of clinical microbiologists and infectious disease clinicians convened by the Association for Diagnostics & Laboratory Medicine (ADLM, formerly AACC, Washington, D.C., USA), with endorsement from the Pan American Society for Clinical Virology. Reflecting the latest insights from COVID-19 and other respiratory virus research, the document advocates for the use of nasopharyngeal samples for upper respiratory tract infections and suggests employing nucleic acid amplification testing whenever feasible. It emphasizes that the interpretation of viral load results should be considered alongside clinical symptoms.

Moreover, the guidance underlines the importance of diagnostic stewardship in respiratory virus testing, which is crucial for ensuring accurate, clinically relevant outcomes while also conserving laboratory resources. The document also introduces a decision-making algorithm designed to help laboratories identify the most suitable tests for specific cases of respiratory virus infection. This algorithm takes into account whether patients are symptomatic, immunocompromised, and whether a positive test result would alter disease management strategies.

“The current guidance document is the authors’ expert opinion based on the preponderance of available evidence to address key questions related to best practices for laboratory diagnosis of respiratory viral infections,” wrote the guidance document authors Drs. Gregory J. Berry, Tulip A. Jhaveri, Paige M.K. Larkin, Heba Mostafa, and N. Esther Babady. “Laboratorians should remain alert and involved to provide guidance on managing testing and the information obtained from a wider range of testing settings.”