Skip to main content
SpringerLink
Log in

Detection of respiratory bacterial pathogens

  • Chapter
Community-Acquired Pneumonia

Part of the book series: Birkhäuser Advances in Infectious Diseases ((BAID))

  • 1837 Accesses

Abstract

Microbiology of community-acquired pneumonia often is based on indirect or precarious evidence. Time and effort to detect a respiratory pathogen often is not sufficiently related to its usefulness in guiding therapy. If sputa are accepted by the laboratory for microbiological studies (Gram stain, culture), they should fulfill quality criteria such as high number of leukocytes and low number of squamous epithelial cells. Complementary tests such as antigen detection assays are useful adjuncts for diagnosing pneumococcal and Legionella pneumonia. Nucleic amplification tests help to overcome the problems in detecting Chlamydia pneumoniae, Legionella and Mycoplasma pneumoniae.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Farr BM, Kaiser DL, Harrison BD, Connolly CK (1989) Prediction of microbial aetiology at admission to hospital for pneumonia from the presenting clinical features. British Thoracic Society Pneumonia Research Subcommittee. Thorax 44: 1031–1035

    Article  PubMed  CAS  Google Scholar 

  2. Bartlett RC (1974) Establishing clinical relevance. In: RC Bartlett (ed): Medical microbiology: cost and relevance. John Wiley & Sons, New York, NY

    Google Scholar 

  3. Sharp SE, Robinson A, Saubolle M, Santa Cruz M, Carrol K, Baselski V (2004) Lower respiratory tract infections. In: LA Weissfeld (ed): Cumulative technique and procedures in clinical microbiology. American Society for Microbiology, Washington, DC

    Google Scholar 

  4. Niederman MS, Mandell LA, Anzueto A, Bass JB, Broughton WA, Campbell GD, Dean N, File T, Fine MJ, Gross PA et al (2001) Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med 163: 1730–1754

    PubMed  CAS  Google Scholar 

  5. Bartlett JG (2004) Decline in microbial studies for patients with pulmonary infections. Clin Infect Dis 39: 170–172

    Article  PubMed  Google Scholar 

  6. Bartlett JG, Mundy LM (1995) Community-cquired pneumonia. New Engl J Med 333: 1618–1624

    Article  PubMed  CAS  Google Scholar 

  7. Roson B, Carratala J, Verdaguer R, Dorca J, Manresa F, Gudiol F (2000) Prospective study of the usefulness of sputum Gram stain in the initial approach to community-acquired pneumonia requiring hospitalization. Clin Infect Dis 31: 869–874

    Article  PubMed  CAS  Google Scholar 

  8. Kalin M, Lindberg AA, Tunevall G (1983) Etiological diagnosis of bacterial pneumonia by Gram stain and quantitative culture of expectorates. Leukocytes or alveolar macrophages as indicators of sample representativity. Scand J Infect Dis 15: 153–160

    PubMed  CAS  Google Scholar 

  9. Barenfanger J, Arakere P, Cruz RD, Imran A, Drake C, Lawhorn J, Verhulst SJ, Khardori N (2003) Improved outcomes associated with limiting identification of Candida spp. in respiratory secretions. J Clin Microbiol 41: 5645–5649

    Article  PubMed  Google Scholar 

  10. Musher DM, Montoya R, Wanahita A (2004) Diagnostic value of microscopic examination of Gram-stained sputum and sputum cultures in patients with bacteremic pneumococcal pneumonia. Clin Infect Dis 39: 165–169

    Article  PubMed  Google Scholar 

  11. Reed WW, Byrd GS, Gates RH, Howard RS, Weaver MJ (1996) Sputum Gram’s stain in community-acquired pneumococcal pneumonia. A meta-analysis. West J Med 165: 197–204

    PubMed  CAS  Google Scholar 

  12. Heineman JS, Chawla JK, Lofton WM (1977) Misinformation from sputum cultures without microscopic examination. J Clin Microbiol 6: 518–527

    PubMed  CAS  Google Scholar 

  13. Lidman C, Burman LG, Lagergren A, Ortqvist A (2002) Limited value of routine microbiological diagnostics in patients hospitalized for communityacquired pneumonia. Scand J Infect Dis 34: 873–879

    Article  PubMed  CAS  Google Scholar 

  14. Theerthakarai R, El Halees W, Ismail M, Solis RA, Khan MA (2001) Nonvalue of the initial microbiological studies in the management of nonsevere community-acquired pneumonia. Chest 119: 181–184

    Article  PubMed  CAS  Google Scholar 

  15. Gutierrez F, Masia M, Rodriguez JC, Ayelo A, Soldan B, Cebrian L, Mirete C, Royo G, Hidalgo AM (2003) Evaluation of the immunochromatographic Binax NOW assay for detection of Streptococcus pneumoniae urinary antigen in a prospective study of community-acquired pneumonia in Spain. Clin Infect Dis 36: 286–292

    Article  PubMed  CAS  Google Scholar 

  16. Ishida T, Hashimoto T, Arita M, Tojo Y, Tachibana H, Jinnai M (2004) A 3-year prospective study of a urinary antigen-detection test for Streptococcus pneumoniae in community-acquired pneumonia: utility and clinical impact on the reported etiology. J Infect Chemother 10: 359–363

    Article  PubMed  CAS  Google Scholar 

  17. Murdoch DR, Laing RTR, Mills GD, Karalus NC, Town GI, Mirrett S, Reller LB (2001) Evaluation of a rapid immunochromatographic test for detection of Streptococcus pneumoniae antigen in urine samples from adults with community-acquired pneumonia. J Clin Microbiol 39: 3495–3498

    Article  PubMed  CAS  Google Scholar 

  18. Navarro D, Garcia-Maet L, Gimeno C, Escribano A, Garcia-de-Lomas J, and theSpanish pneumococcal study network (2004) Performance of the binax NOW Streptococcus pneumoniae urinary antigen assay for diagnosis of pneumonia in children with underlying pulmonary diseases in the absence of acute pneumococcal infection. J Clin Microbiol 42: 4853–4855

    Article  PubMed  Google Scholar 

  19. Murdoch DR, Anderson TP, Beynon KA, Chua A, Fleming AM, Laing RTR, Town GI, Mills GD, Chambers ST, Jennings LC (2003) Evaluation of a PCR assay for detection of Streptococcus pneumoniae in respiratory and nonrespiratory samples from adults with community-acquired pneumonia. J Clin Microbiol 41: 63–66

    Article  PubMed  CAS  Google Scholar 

  20. Campos J, Hernando M, Roman F, Perez-Vazquez M, Aracil B, Oteo J, Lazaro E, de Abajo F, and the Group of Invasive Haemophilus Infections of the Autonomous Community of Madrid (2004) Analysis of invasive Haemophilus influenzae infections after extensive vaccination against H. influenzae Type b. J Clin Microbiol 42: 524–529

    Article  PubMed  Google Scholar 

  21. Tenover FC, Edelstein PH, Goldstein LC, Sturge JC, Plorde JJ (1986) Comparison of cross-staining reactions by Pseudomonas spp. and fluorescein-labeled polyclonal and monoclonal antibodies directed against Legionella pneumophila. J Clin Microbiol 23: 647–649

    PubMed  CAS  Google Scholar 

  22. Yzerman EPF, Boer JW, Lettinga KD, Schellekens J, Dankert J, Peeters M (2002) Sensitivity of three urinary antigen tests associated with clinical severity in a large outbreak of Legionnaires’ disease in the Netherlands. J Clin Microbiol 40: 3232–3236

    Article  PubMed  Google Scholar 

  23. Guerrero C, Toldos CM, Yague G, Ramirez C, Rodriguez T, Segovia M (2004) Comparison of diagnostic sensitivities of three assays (Bartels Enzyme Immunoassay [EIA], Biotest EIA, and Binax NOW Immunochromatographic Test) for detection of Legionella pneumophila serogroup 1 antigen in urine. J Clin Microbiol 42: 467–468

    Article  PubMed  Google Scholar 

  24. Reischl U, Linder H, Lehn N, Landt O, Barratt K, Wellinghausen N (2002) Direct detection and differentiation of Legionella spp. and Legionella pneumophila in clinical specimens by dual-color real-time PCR and melting curve analysis. J Clin Microbiol 40: 3814–3817

    Article  PubMed  CAS  Google Scholar 

  25. Templeton KE, Scheltinga SA, van den Eeden WC, Graffelman AW, van den Broek PJ, Claas EC (2005) Improved diagnosis of the etiology of communityacquired pneumonia with real-time polymerase chain reaction. Clin Infect Dis 41: 345–351

    Article  PubMed  Google Scholar 

  26. Tsolia MN, Psarras S, Bossios A, Audi H, Paldanius M, Gourgiotis D, Kallergi K, Kafetzis DA, Constantopoulos A, Papadopoulos NG (2004) Etiology of community-acquired pneumonia in hospitalized school-age children: evidence for high prevalence of viral infections. Clin Infect Dis 39: 681–686

    Article  PubMed  CAS  Google Scholar 

  27. Weigl JA, Puppe W, Grondahl B, Schmitt HJ (2000) Epidemiological investigation of nine respiratory pathogens in hospitalized children in Germany using multiplex reverse-transcriptase polymerase chain reaction. Eur J Clin Microbiol Infect Dis 19: 336–343

    Article  PubMed  CAS  Google Scholar 

  28. Wellinghausen N, Straube E, Freidank H, von Baum H, Marre R, Essig A (2006) Low prevalence of Chlamydia pneumoniae in community-acquired pneumonia. Int J Med Microbiol; in press

    Google Scholar 

  29. Dowell SF, Peeling R, Boman J, Carlone GM, Fields BS, Guarner J, Hammerschlag MR, Jackson LA, Chou-Chou K, Maass M et al (2001) Standardizing Chlamydia pneumoniae assays: recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada). Clin Infect Dis 33: 492–502

    Article  PubMed  CAS  Google Scholar 

  30. Apfalter P, Blasi F, Boman J, Gaydos CA, Kundi M, Maass M, Makristathis A, Meijer A, Nadrchal R, Persson K et al (2001) Multicenter comparison trial of DNA extraction methods and PCR assays for detection of Chlamydia pneumoniae in endarterectomy specimens. J Clin Microbiol 39: 519–524

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Ulm, Institute of Medical Microbiology & Hygiene, Robert-Koch-Str. 8, 89081 Ulm, Germany

    Reinhard Marre

Authors
  1. Reinhard Marre
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Birkhäuser Verlag Basel/Switzerland

About this chapter

Cite this chapter

Marre, R. (2007). Detection of respiratory bacterial pathogens. In: Community-Acquired Pneumonia. Birkhäuser Advances in Infectious Diseases. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-7563-8_2

Download citation

Publish with us

Policies and ethics

Search

Navigation