Am. J. Respir. Crit. Care Med., Vol 152, No. 1, Jul 1995, 11-16.
The polymerase chain reaction in the diagnosis and evaluation of pulmonary infections
NW Schluger and WN Rom
Bellevue Chest Service, New York University Medical Center, New York, USA.
One of the most heralded developments in basic science to reach clinical
application in recent years has been the polymerase chain reaction (PCR).
This technique of DNA amplification, which has already had an enormous
effect on the way in which molecular biology research is done (and whose
inventor, Kary Mullis, was awarded the Nobel Prize in Chemistry in 1993 in
recognition of the extraordinary impact of PCR technology on scientific
research generally), was quickly appreciated by clinical investigators as
having potentially widespread utility in the early diagnosis of a wide
range of disorders, such as inherited illnesses and infectious diseases
(1). This Commentary will review the application of PCR to the diagnosis
and evaluation of respiratory infections. The underlying principle guiding
this Commentary is that the ideal diagnostic test for respiratory
infectious disease should have the following characteristics: high
sensitivity and specificity, high positive and negative predictive value,
rapid turnaround time, ease of performance, reliability across samples (the
same sample tested repeatedly should give the same result) and across those
performing the assay (different laboratories performing the assay on the
same specimen will report the same result), and low cost. It is against
these criteria that PCR will be measured in this review.
