Rapid diagnostic tests for defining the cause of community-acquired pneumonia.

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We review the potential new diagnostic tools for determining the cause of pneumonia in the setting of community-acquired infection after outlining the limitation of currently available tests. A number of new tools are on the horizon with the potential to overcome the problems of existing tests. These tools include new nucleic acid amplification platforms, real-time computer-assisted microscopy, next-generation sequencing and high-throughput mass spectrometry. All of these tests still face significant barriers before they can enter general clinical practice including cost, reliability and physician acceptance. Although new platforms are exciting and do offer the promise of finally moving beyond our current very limited scope of microbiological tests, empiric therapy based on knowledge of local epidemiological data is likely to remain the standard of care until the hurdles of proven accuracy, physician acceptance and cost-effectiveness are successfully negotiated.