HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Laboratory diagnosis of nosocomial pneumonia.

Abstract
The second most common nosocomial infection in the United States is pneumonia, with the highest rates seen in patients requiring mechanical ventilation. Nosocomial pneumonia is a serious disease associated with significant morbidity and mortality; crude mortality rates have been estimated at 20% to 50%. The rapid institution of appropriate antimicrobial therapy has been shown to improve mortality in patients with ventilator associated nosocomial pneumonia. Thus, the identification of nosocomial pneumonia with a timely microbiologic diagnosis is important for the management of these patients. However, the accurate diagnosis of nosocomial pneumonia, along with identification of the responsible organism(s), can be challenging. This task becomes even more difficult in patients who are mechanically ventilated. The presence of new pulmonary infiltrates along with clinical criteria including fever, cough, and purulent secretions are neither sensitive nor specific for the diagnosis of nosocomial pneumonia. The laboratory can enhance the accuracy of pneumonia diagnosis, as well as provide the identification of an etiologic organism(s). There are, however, many challenges which confront the laboratory including: the ability to identify organisms from an extensive microbiologic spectrum; distinguishing colonization from infection of predominately gram-negative oropharyngeal flora; and providing timely results. This article reviews the various diagnostic tests available for nosocomial lung infections, and in particular, ventilator associated pneumonia including: blood cultures; pleural fluid; expectorated sputum; endotracheal aspirates; and respiratory specimens obtained by more invasive techniques using bronchoscopy and transthoracic needle aspiration. Emphasis is placed on optimal specimen collection, the processing of samples in the laboratory, and on the evaluation of potential risks and benefits associated with the varying techniques.
AuthorsJ Mayer
JournalSeminars in respiratory infections (Semin Respir Infect) Vol. 15 Issue 2 Pg. 119-31 (Jun 2000) ISSN: 0882-0546 [Print] United States
PMID10983930 (Publication Type: Journal Article, Review)
Topics
  • Bacteria, Anaerobic (isolation & purification)
  • Clinical Laboratory Techniques
  • Cross Infection (diagnosis, epidemiology)
  • Female
  • Gram-Negative Bacteria (isolation & purification)
  • Gram-Positive Bacteria (isolation & purification)
  • Humans
  • Incidence
  • Lung Diseases, Fungal (diagnosis, epidemiology)
  • Male
  • Pneumonia, Bacterial (diagnosis, epidemiology)
  • Risk Factors
  • United States (epidemiology)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: