Gilbert David, Gelfer Gita, Wang Lian, Myers Jillian, Bajema Kristina, Johnston Michael, Leggett James
Providence Portland Medical Center, Portland, OR, USA.
Providence Portland Medical Center, Portland, OR, USA.
Diagn Microbiol Infect Dis. 2016 Sep;86(1):102-7. doi: 10.1016/j.diagmicrobio.2016.06.008. Epub 2016 Jun 15.
Two diagnostic bundles were compared in 127 evaluable patients admitted with community-acquired pneumonia (CAP). Diagnostic modalities in all patients included cultures of sputum (if obtainable) and blood, urine for detection of the antigens of Streptococcus pneumoniae and Legionella pneumophila, and nasal swabs for PCR probes for S. pneumoniae and Staphylococcus aureus. At least one procalcitonin level was measured in all patients. For virus detection, patients were randomized to either a 5-virus, lab-generated PCR panel or the broader and faster FilmArray PCR panel. Overall, an etiologic diagnosis was established in 71% of the patients. A respiratory virus was detected in 39%. The potential for improved antibiotic stewardship was evident in 25 patients with only detectable respiratory virus and normal levels of PCT.
在127例因社区获得性肺炎（CAP）入院的可评估患者中，对两种诊断组合进行了比较。所有患者的诊断方法包括痰液（若可获取）和血液培养、检测肺炎链球菌和嗜肺军团菌抗原的尿液检测，以及用于肺炎链球菌和金黄色葡萄球菌PCR探针的鼻拭子检测。所有患者均至少检测了一次降钙素原水平。为了检测病毒，患者被随机分为接受实验室生成的5病毒PCR检测组或更广泛、更快速的FilmArray PCR检测组。总体而言，71%的患者确立了病因诊断。39%的患者检测到呼吸道病毒。在仅检测到呼吸道病毒且降钙素原水平正常的25例患者中，改善抗生素管理的潜力显而易见。
