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Nasopharyngeal culture in the pneumonia diagnosis

Nasopharynx-Kultur in der Pneumonie-Diagnostik

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Summary

The diagnostic value of bacterial cultures from nasopharynx (NPH) was prospectively studied in 261 patients with community-acquired pneumonia requiring hospitalization. NPH culture results were compared with those of other diagnostic methods: Culture from blood and sputum, pneumococcal antigen detection, enzyme immuno assay (EIA) for detection of antibodies against pneumococcal hemolysin and in selected cases bronchoscopy. Pneumococcal pneumonia was diagnosed by these other methods in 121 patients.Streptococcus pneumoniae was detected in NPH in 33 of these patients (27%, or 36% if only cultures obtained before start of antibiotics are considered), but in only four of the other 140 patients. For other species the relevance of NPH culture was uncertain. Because of its simplicity and high specificity NPH culture can be a valuable supplement to other diagnostic methods, particularly when sputum samples are difficult to obtain.

Zusammenfassung

Der diagnostische Wert der Bakterienkultur vom Nasopharynx (NPH) wurde prospektiv an 261 Patienten mit außerhalb des Krankenhauses erworbener Pneumonie, die Krankenhausbehandlung erforderte, untersucht. Die Resultate der NPH-Kultur wurden mit denen von anderen diagnostischen Methoden verglichen: Kulturen von Blut und Sputum, Nachweis von Pneumokokkenantigenen, ELISA für den Nachweis von Antikörpern gegen Pneumokokkenhämolysin und in ausgewählten Fällen Bronchoscopie. Mit diesen anderen Methoden wurde bei 121 Patienten eine Pneumokokkenpneumonie diagnostiziert.Streptococcus pneumoniae wurde im NPH von 33 dieser Patienten entdeckt, aber nur bei vier der anderen 140 Patienten. Für andere Spezies war die Relevanz der NPH-Kultur unsicher. Wegen ihrer Einfachheit und hohen Spezifizität kann die NPH-Kultur eine wertvolle Ergänzung von anderen Methoden werden, besonders wenn Sputumproben schwer zu erhalten sind.

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References

  1. Foy, H. M., Wentworth, B., Kenny, G. E., Kloeck, J. M., Grayston, J. I. Pneumococcal isolations from patients with pneumonia and control subjects in a prepaid medical care group. Am. Rev. Resp. Dis. 111 (1975) 595–603.

    Google Scholar 

  2. Kalin, M., Lindberg, A. A. Diagnosis of pneumococcal pneumonia: A comparison between microscopic examination of expectorate, antigen detection and cultural procedures. Scand. J. Infect. Dis. 15 (1983) 247–255.

    Google Scholar 

  3. Holmberg, H. Aetiology of community-acquired pneumonia in hospital treated patients. Scand. J. Infect. Dis. 19 (1987) 491–501.

    Google Scholar 

  4. Örtqvist, Å., Kalin, M., Lejdeborn, L., Lundberg, B. Usefulness of diagnostic fiberoptic bronchoscopy and protected brush culture in the management of patients with community-acquired pneumonia. Chest 97 (1990) 576–582.

    Google Scholar 

  5. Örtqvist, Å., Grillner, L., Hedlund, J., Jalonen, E., Kallings, I., Leinonen, M., Kalin, M.: Outcome and prognostic factors in patients with community-acquired pneumonia requiring hospitalisation. Eur. Resp. J. 1990, in press.

  6. Bartlett, J. G., Finegold, S. M. Bacteriology of expectorated sputum with quantitative culture and wash technique compared to transtracheal aspirates. Am. Rev. Resp. Dis. 117 (1978) 1019–1027.

    Google Scholar 

  7. Heinemann, H. S., Chawla, J. K., Lofton, W. M. Misinformation from sputum cultures without microscopic examination. J. Clin. Microbiol. 6 (1977) 518–527.

    Google Scholar 

  8. Kalin, M., Lindberg, A. A., Olausson, E-H. Diagnosis of pneumococcal pneumonia by coagglutination and counterimmunoelectrophoresis of sputum samples. Eur. J. Clin. Microbiol. 1 (1982) 91–96.

    Google Scholar 

  9. Örtqvist, Å., Jönsson, I., Kalin, M., Krook, A. Comparison of three methods for detection of pneumococcal antigen in sputum of patients with community-acquired pneumonia. Eur. J. Clin. Microbiol. Infect. Dis. 8 (1989) 956–961.

    Google Scholar 

  10. Kalin, M. Bacteremic pneumococcal pneumonia: Value of nasopharynx culture and examination of washed sputum specimens. Eur. J. Clin. Microbiol. 1 (1982) 394–396.

    Google Scholar 

  11. Fransén, H., Tunevall, G. Bacteria and serologic reactions against bacteria in patients hospitalized with acute respiratory illness. Scand. J. Infect. Dis. 1 (1969) 191–202.

    Google Scholar 

  12. Hendley, J. O., Sande, M. A., Stewart, P. M., Gwaltney, J. M. Spread ofStreptococcus pneumoniae in families. I Carriage rates and distribution of types. J. Infect. Dis. 132 (1975) 55–61.

    Google Scholar 

  13. Krantz, I., Alestig, K., Trollfors, B., Zackrisson, G. The carrier state in pertussis. Scand. J. Infect. Dis. 18 (1986) 121–123.

    Google Scholar 

  14. Winther, B., Brofeldt, S., Groenborg, H., Mygind, N., Pedersen, S., Veilsgaard, R. Study of bacteria in the nasal cavity and nasopharynx during naturally acquired common colds. Acta Otolaryngol (Stockholm) 98 (1984) 315–320.

    Google Scholar 

  15. Steinum, O., Alestig, K., Brorson, J-E. Culture from epipharynx of little value in bacterial pneumonia. Scand. J. Infect. Dis. 19 (1987) 309–312.

    Google Scholar 

  16. Kalin, M., Kanclerski, K., Granström, M., Möllby, R. Diagnosis of pneumococcal pneumonia by enzyme linked immunosorbent assay of antibodies to pneumococcal hemolysin (pneumolysin). J. Clin. Microbiol. 25 (1987) 226–229.

    Google Scholar 

  17. Jalonen, E., Paton, J. C., Koskela, M., Kerttula, Y., Leinonen, M. Measurement of antibody responses to pneumolysin — a promising method for presumptive aetiological diagnosis of pneumococcal pneumonia. J. Infect. 19 (1989) 127–134.

    Google Scholar 

  18. Kalin, M., Lindberg, A. A., Tunevall, G. Etiological diagnosis of bacterial pneumonia by Gram stain and quantitative culture of expectorates. Scand. J. Infect. Dis. 15 (1983) 153–160.

    Google Scholar 

  19. Alexander, H. E., Craig, H. R., Shirley, R. G., Ellis, C. Validity of etiological diagnosis of pneumonia in children by rapid typing from nasopharyngeal mucus. J. Pediatr. 18 (1941) 31–35.

    Google Scholar 

  20. Auger, W. J. An original method of obtaining sputum from infants and children. With reference to the incidence of pneumococci in the nasopharynx. J. Pediatr. 15 (1933) 640–645.

    Google Scholar 

  21. Felty, A. R., Heatley, C. A. The nasal passages in lobar pneumonia. A clinical and bacteriologic study. JAMA 86 (1926) 1195–1197.

    Google Scholar 

  22. Hodes, H. L., Stifler, W. C., Walker, E., McCarthy, M., Shirley, R. G. The use of sulfapyridine in primary pneumococcic pneumonia and pneumococcic pneumonia associated with measles. J. Pediatr. 14 (1939) 417–46.

    Google Scholar 

  23. Kamme, C., Lundgren, K., Mårdh., P-A. The aetiology of acute otitis media in children. Occurrence of bacteria, L forms of bacteria and mycoplasma in the middle ear exudate. Relationship between bacterial findings in the middle ear exudate, nasopharynx and throat. Scand. J. Infect. Dis. 3 (1971) 217–223.

    Google Scholar 

  24. Henderson, F. W., Giebink, G. S. Otitis media among children in day care: Epidemiology and pathogenesis. Rev. Infect. Dis. 8 (1986) 533–538.

    Google Scholar 

  25. Loos, B. G., Bernstein, J. M., Dryja, D. M., Murphy, T. F., Dickinson, D. P. Determination of the epidemiology and transmission of nontypeableHaemophilus influenzae in children with otitis media by comparison of total genomic DNA restriction fingerprints. Infect. and Immun. 57 (1989) 2751–2757.

    Google Scholar 

  26. Murphy, T. F., Bernstein, J. M., Dryja, D. M., Canpagnary, A. A., Apicella, M. A. Outer membrane protein and lipooligosaccharide analysis of paired nasopharyngeal and middle ear isolates in otitis media due to nontypableHaemophilus influenza: Pathogenetic and epidemiological observations. J. Infect. Dis. 156 (1987) 723–731.

    Google Scholar 

  27. Roberts, R. B. Streptococcus pneumoniae. In:Mandell, G. L., Douglas, R. G., Bennet, J. E. (eds): Principles and practice of infectious diseases. Churchill Livingstone Inc., New York 1985, pp. 1142–1151.

    Google Scholar 

  28. Davidson, M., Tempest, B., Palmer, D. L. Bacteriologic diagnosis of acute pneumonia. Comparison of sputum, transtracheal aspirates, and lung aspirates. JAMA 235 (1976) 158–163.

    Google Scholar 

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Authors and Affiliations

  1. Department of Infectious Diseases, Danderyd Hospital, S-18288, Danderyd, Sweden

    J. Hedlund M. D., Å. Örtqvist M. D. Ph. D. & M. Kalin M. D. Ph. D.

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  1. J. Hedlund M. D.
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  2. Å. Örtqvist M. D. Ph. D.
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  3. M. Kalin M. D. Ph. D.
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Hedlund, J., Örtqvist, Å. & Kalin, M. Nasopharyngeal culture in the pneumonia diagnosis. Infection 18, 283–285 (1990). https://doi.org/10.1007/BF01647005

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