[New developments in bedside diagnosis].

Abstract

The time required to isolate microorganisms, identify them, interpret results, and provide guidance for therapy is inordinate for urgent decisions in primary care. The emphasis for a more rapid diagnosis bedside or in the office, respectively, is caused apart from medical reasons by economic restrictions necessitating earlier diagnosis, more immediate and appropriate treatment, shorter patient hospital stays, and allowing the patient to resume normal productivity earlier. After describing some general criteria with regard to the design of tests for bed-side diagnosis we discuss well known and novel procedures: microscopy of clinical specimens, microbial antigen detection, and nucleic acid hybridization. In concluding remarks we underline the necessity of careful clinical studies concerning sensitivity, specificity, and reliability as well as quality control measures for every novel assay before and during introduction in clinical and office practice.