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New Methods for Bacterial Diagnosis in Patients with Hematological Malignancies

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Book cover Pulmonary Involvement in Patients with Hematological Malignancies

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Abstract

Establishing the diagnosis of pulmonary infection in patients with hematological malignancies (HM) is a major challenge. Molecular diagnostic tools and antigen assays may improve diagnosis rates, although their performance has not been specifically evaluated in patients with HM. PCR is useful for circumventing the difficulties encountered in culturing atypical organisms (i.e., Mycoplasma pneumoniae and Chlamydophila pneumoniae). Similarly, the rapid PCR diagnosis of Legionella pneumophila in lung samples is a helpful complement to antigen detection in urine and may improve the detection of Legionella species other than L. pneumophila serogroup 1. Mycobacterium tuberculosis PCR can significantly shorten the time to diagnosis when direct detection is positive. PCR identification of pyogenic bacteria, particularly Streptococcus pneumoniae, can overcome the limited sensitivity of culture and antigen detection in urine, although standardized quantification is crucial to differentiate infection from contamination by the nasopharyngeal tract, and a thorough evaluation is therefore required. Universal PCR is valuable for detecting nontargeted bacteria in culture-negative samples, but has been evaluated only with pleural fluid. Finally, multiplex PCRs, by screening a large panel of microorganisms, are very promising techniques for one-step identification of viruses and atypical bacteria responsible for pulmonary infections. Urinary antigen detection is available only for L. pneumophila serogroup 1 and S. pneumoniae. Some studies obtained good results with S. pneumoniae antigen detection in pleural fluid and bronchoalveolar lavage fluid.

The role for these new techniques needs to be evaluated in the specific field of HM.

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  1. Laboratoire de Microbiologie, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades and Université René Descartes Paris 5, Faculté de Médecine, 149 Rue de Sèvres, 75015, Paris, France

    Agnès Ferroni & Jean-Ralph Zahar

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    Elie Azoulay

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Ferroni, A., Zahar, JR. (2011). New Methods for Bacterial Diagnosis in Patients with Hematological Malignancies. In: Azoulay, E. (eds) Pulmonary Involvement in Patients with Hematological Malignancies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-15742-4_18

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  • DOI: https://doi.org/10.1007/978-3-642-15742-4_18

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