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社区获得性肺炎潜在病原体检测的临床影响。

The clinical impact of the detection of potential etiologic pathogens of community-acquired pneumonia.

作者信息

Gelfer Gita, Leggett James, Myers Jillian, Wang Luan, Gilbert David N

机构信息

Providence Portland Medical Center, Portland, OR, USA.

Providence Portland Medical Center, Portland, OR, USA.

出版信息

Diagn Microbiol Infect Dis. 2015 Dec;83(4):400-6. doi: 10.1016/j.diagmicrobio.2015.08.001. Epub 2015 Aug 5.

Abstract

The etiology of community-acquired pneumonia (CAP) is determined in less than half of the patients based on cultures of sputum and blood plus testing urine for the antigens of Streptococcus pneumoniae and Legionella pneumophila. This study added nasal polymerase chain reaction (PCR) probes for S. pneumoniae, Staphylococcus aureus, and respiratory viruses. Serum procalcitonin (PCT) levels were measured. Pathogens were identified in 78% of the patients. For detection of viruses, patients were randomized to either a 5-virus laboratory-generated PCR bundle or the 17-virus FilmArray PCR platform. The FilmArray PCR platform detected more viruses than the laboratory-generated bundle and did so in less than 2 hours. There were fewer days of antibiotic therapy, P = 0.003, in CAP patients with viral infections and a low serum PCT levels.

摘要

根据痰液和血液培养结果以及检测尿液中肺炎链球菌和嗜肺军团菌的抗原,不到一半的社区获得性肺炎(CAP)患者能够明确病因。本研究增加了针对肺炎链球菌、金黄色葡萄球菌和呼吸道病毒的鼻聚合酶链反应(PCR)探针。检测了血清降钙素原(PCT)水平。78%的患者确定了病原体。为了检测病毒,患者被随机分为接受5种病毒实验室自制PCR检测组合或17种病毒的FilmArray PCR平台检测。FilmArray PCR平台检测到的病毒比实验室自制检测组合更多,且检测时间不到2小时。病毒感染且血清PCT水平较低的CAP患者接受抗生素治疗的天数较少,P = 0.003。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c755/7125660/4a16fd4fa4ae/gr1_lrg.jpg

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