Review article

Microbiological Diagnostics of Community-Acquired Pneumonia

Ivana Mareković
Denis Baričević
Nataša Firis

Abstract

Community-acquired pneumonia is an important cause of morbidity and mortality. Even with microbiological investigation done, the etiology frequently remains unknown. In the last 20 years the interest in and the need for microbiological tests in patients with community-acquired pneumonia have decreased, so today the majority of patients do not have the causative agent detected. Limitations regarding the use of microbiological tests are also found in the guidelines for diagnostics and treatment of community-acquired pneumonia. Microbiological investigation is indicated in hospitalized patients in order to administer pathogen-directed treatment, ensure rational administration of antibiotics and achieve savings in the cost of treatment. Urinary antigen tests for pneumococcus and legionella have a specific place among microbiological tests. Their greatest advantages are tests results obtained in only 15 minutes and their simplicity. Molecular methods have not been standardized, but the detection of pneumococcus in respiratory samples in patients previously treated with antibiotics has been improved. As a result of the imperfections of microbiological tests, biomarkers are investigated as indicators of community-acquired pneumonia etiology. The values of such biomarkers have been used for assessing the length of therapy and differentiating between bacterial and viral infections. Research has shown that procalcitonin levels can assist in making a decision about the duration of antimicrobial treatment. The future of microbiological diagnostics will most probably be point-of-care tests which can easily be performed by medical staff outside the laboratory, as well as further development and standardization of molecular tests to enable their routine use.

Keywords

pneumonia; innate immunity; adaptive immunity; immunomodulatory effect of antibiotics

Hrčak ID:

161760

URI

https://hrcak.srce.hr/161760

Publication date:

13.7.2016.

Article data in other languages: croatian

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