Clark Julia E
Arch Dis Child. 2015 Feb;100(2):193-7. doi: 10.1136/archdischild-2013-305742. Epub 2014 Sep 22.
Over recent years non-culture techniques such as specific viral and bacterial nucleic acid amplification, serology and antigen detection have considerably developed and been applied within research studies to clinical samples, significantly increasing pathogen detection in pneumonia. There are promising signs of improved diagnostic yields for pneumococcal pneumonia when using molecular techniques to detect pneumococcal gene sequences in blood or by combining serum biomarkers with rapid pneumococcal urinary antigen testing. Pathogens have traditionally been difficult to detect in pneumonia and treatment is usually successful with empiric antibiotics. However, directed antibiotic treatment has significant benefits in terms of antibiotic stewardship and these new technologies make this goal a possibility, though not yet a reality.
近年来,诸如特定病毒和细菌核酸扩增、血清学及抗原检测等非培养技术有了长足发展,并已在研究中应用于临床样本,显著提高了肺炎病原体的检测率。当使用分子技术检测血液中的肺炎球菌基因序列,或将血清生物标志物与快速肺炎球菌尿抗原检测相结合时,有迹象表明肺炎球菌肺炎的诊断率有望提高。传统上,肺炎中的病原体很难检测到,治疗通常使用经验性抗生素且较为成功。然而,针对性抗生素治疗在抗生素管理方面具有显著益处,尽管这些新技术使这一目标成为可能,但尚未成为现实。