Rapid Diagnostic Testing as a Tool for Guiding Treatment of Infectious Disease in Elite Athletes

Abstract

PURPOSE: To describe the most common etiologies of upper respiratory tract infections (URI) in elite athletes presenting to an ambulatory sports medicine clinic as diagnosed with polymerase chain reaction rapid diagnostic testing (PCR). METHODS: Retrospective analysis of medical records from 42 patient-athletes who presented to a sports medicine clinic for evaluation of URI. Clinic care pathways identify a criterion for the implementing PCR testing of patient’s presenting with symptoms and objective signs of an URI. Descriptive statistics were used to describe the etiology of URI in this cohort. RESULTS: 42 URI cases met clinical criteria for PCR testing. 22 of these cases yielded positive identification of at least one pathogen. 21 of the 22 positive cases represented viral agents (95%). Influenza was the responsible agent in 50% of positive cases. Chlamydia pneumoniae was the sole bacterial pathogen identified. There were 3 cases of co-infection composed of multiple viral pathogens. CONCLUSION: Viral pathogens are the most common cause of URI in the elite athlete population. The identification of viral URI with PCR testing in athlete populations provides for the opportunity to implement evidence-based management. The significant number of negative PCR findings in patients with upper respiratory symptoms suggests there are additional unidentified etiologies for respiratory symptoms in athletes. The impact of PCR on the treatment strategies and outcomes of URI requires further investigation.