title: Aetiological diagnosis of community acquired pneumonia: utility of rapid microbiological methods with respect to disease severity.
abstract: The present study investigated the utility of rapid microbiological methods in the aetiological diagnosis of community acquired pneumonia (CAP) according to the severity of CAP. Between 1999 and 2004, 384 adult patients with CAP were studied prospectively. In addition to standard microbiological methods, PCR and antigen detection techniques were used to identify pathogens. A total of 230 microbial agents in 209 patients were identified, with 134 (58.2%) identified by antigen detection or PCR tests. Of these 134 microbial agents, 95 (70.9%) were identified only by these rapid methods. Streptococcus pneumoniae urinary antigen detection was positive in 24.3% (81/333) of the patients with a diagnostic yield of 38.7% in those with severe pneumonia. Respiratory viral antigen detection was positive in 11.1% (35/314) of the patients with the highest diagnostic yield (20.3%) in patients with severe pneumonia. Mycoplasma pneumoniae PCR was positive in 7.5% (13/174) of the patients, all of whom were low-risk patients. Only 1 case of Chlamydia pneumoniae was identified by PCR. In conclusion, besides yielding the aetiological diagnosis rapidly, new methods add to the total diagnostic yield in CAP. The diagnostic yield of rapid methods differs according to the severity of the pneumonia.
authors.affiliation: Department of Medicine, Turku University Hospital, Finland. ulla.hohenthal@tyks.fi
authors.forename: Ulla
authors.initials: U
authors.lastname: Hohenthal
authors.forename: Raija
authors.initials: R
authors.lastname: Vainionpää
authors.forename: Olli
authors.initials: O
authors.lastname: Meurman
authors.forename: Anna
authors.initials: A
authors.lastname: Vahtera
authors.forename: Terhi
authors.initials: T
authors.lastname: Katiskalahti
authors.forename: Jukka
authors.initials: J
authors.lastname: Nikoskelainen
authors.forename: Pirkko
authors.initials: P
authors.lastname: Kotilainen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001769:Blood / Q000382:microbiology / Q000821:virology; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology / Q000821:virology; D017714:Community-Acquired Infections / Q000382:microbiology / Q000821:virology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis* / Q000382:microbiology / Q000821:virology; D011933:Reagent Kits, Diagnostic / Q000382:microbiology / Q000821:virology; D013183:Sputum / Q000382:microbiology / Q000821:virology; D014556:Urine / Q000382:microbiology / Q000821:virology
chemical_list: D011933:Reagent Kits, Diagnostic