Mittermayer H
Institut für Medizinische Mikrobiologie und Hygiene, A.ö. Krankenhauses der Elisabethinen, Linz.
Acta Med Austriaca. 1997;24(1):8-9.
Procedures for the microbiological diagnosis of acute community-acquired pneumonia are based on the expected pathogens. Although a great variety of microorganisms are able to cause community-acquired pneumonia only a few pathogens play an important role in daily practice. The most important investigations are blood cultures and sputum cultures to detect bacteria like pneumococci, Haemophilus influenzae and Staphylococcus aureus as well as antibody tests for Mycoplasma pneumonia and Chlamydia pneumonia. According to anamnesis and clinic presentation tests such as for Legionella or viruses have to be added. Sometimes also rare pathogens have to be considered such as Coxiella burnetii, Leptospira, Hantaviruses, cryptococci or Chlamydia psittaci. The standard procedure for diagnosis of tuberculosis is the microscopical examination and the standardized culture in liquid and on solid media. Amplification methods such as PCR are also useful for a rapid diagnosis. However, the application of amplification procedures alone without culture is not recommended.
急性社区获得性肺炎的微生物学诊断程序基于预期的病原体。虽然多种微生物都能引起社区获得性肺炎,但在日常实践中只有少数病原体起重要作用。最重要的检查是血培养和痰培养,以检测肺炎球菌、流感嗜血杆菌和金黄色葡萄球菌等细菌,以及肺炎支原体和肺炎衣原体的抗体检测。根据病史和临床表现,必须增加如军团菌或病毒的检测。有时还必须考虑罕见病原体,如伯纳特立克次体、钩端螺旋体、汉坦病毒、隐球菌或鹦鹉热衣原体。结核病诊断的标准程序是显微镜检查以及在液体和固体培养基上的标准化培养。诸如聚合酶链反应(PCR)等扩增方法也有助于快速诊断。然而,不推荐仅使用扩增程序而不进行培养。