Leroy O
Service de réanimation médicale et maladies infectieuses, hôpital G.-Chatiliez, 135, rue du Président-Coty, 59208 Tourcoing, France.
Med Mal Infect. 2006 Nov-Dec;36(11-12):570-98. doi: 10.1016/j.medmal.2006.07.008. Epub 2006 Nov 13.
The diagnosis of community-acquired pneumonia is usually based on clinical and radiological criteria. The identification of a causative organism is not required for the diagnosis. Although numerous microbiological techniques are available, their sensitivity and specificity are not high enough to guide first-line antimicrobial therapy. Consequently, this treatment remains most often empiric. If the causative organism is identified, the antimicrobial treatment is adapted. Sputum analysis may be proposed as a diagnostic tool for patients with an acute exacerbation of chronic obstructive pulmonary disease, in specific cases (prior antibiotherapy, hospitalization, failure of the empiric antimicrobial treatment).
社区获得性肺炎的诊断通常基于临床和影像学标准。诊断时无需确定病原体。尽管有多种微生物学技术可用，但其敏感性和特异性不足以指导一线抗菌治疗。因此，这种治疗通常仍为经验性治疗。如果确定了病原体，则调整抗菌治疗。对于慢性阻塞性肺疾病急性加重的患者，在特定情况下（先前接受过抗生素治疗、住院、经验性抗菌治疗失败），可建议进行痰液分析作为诊断工具。
