Description et place des techniques bactériologiques dans la prise en charge des infections pulmonaires

Abstract

Acute pneumonias occur in a variety of clinical settings and accurate identification of bacterial causes is extremely important. No microbiological tool is either 100 % sensitive or 100 % specific, and despite investigations, aetiology remains unanswered in more than 30 % of pneumonia. No sample may be necessary for patients treated as outpatients, non invasive respiratory specimens are preferred in hospitalised individuals (community or healthcare associated), while invasive specimens are used as second line for community acquired pneumonia (CAP) in intensive care, and in the first line where pneumonia occurs in immunosuppressed patients. Bacterial cultures have an important place, if the sample is taken before the introduction of antibiotic therapy. Some contexts may justify the use of blood cultures, testing for urinary antigens or serology. PCR is already becoming available as a daily service but the short-term future probably belongs to molecular multiplex panels capable of detecting many microorganisms within hours, especially in severe CAP resuscitation and in pneumonia in the immunosuppressed. High-throughput sequencing nucleotide techniques will soon revolutionize microbiological diagnosis in respiratory medicine, as in other areas of infectious diseases.

Pharmacokinetics, efficacy and tolerance of cefoxitin in the treatment of cefoxitin-susceptible extended-spectrum beta-lactamase producing Enterobacterales infections in critically ill patients: a retrospective single-center study

“…All biological samples positive for cefoxitin-susceptible ESBL-PE sent for bacteriological analysis were considered if the amount of bacteria exceeded the threshold defined for the sample site [32,33]. ESBL-PE were suspected based on the antibiotic susceptibility testing, and cefoxitin-susceptibility was assessed following the latest European and French guidelines [34].…”

Bacteriological Profile of Infections Encountered in a Pneumology Service in a Moderate-Income Country [Pneumology Department of CHU Cocody (Cote d’Ivoire)]

“…As for the Cyto-Bacteriological Examination of Sputum, according to a meta-analysis, the sensitivity of the direct examination varies from 15% to 100% in the diagnosis of community pneumonia. This variability can be explained by different characteristics of the populations studied, by the prior administration of antibiotics and depending on the reference test used [14].…”

Application of mNGS in the study of pulmonary microbiome in pneumoconiosis complicated with pulmonary infection patients and exploration of potential biomarkers

“…And many patients with advanced pneumoconiosis die of respiratory failure due to pulmonary infections (Barnes et al, 2019;Qi et al, 2021). Traditional etiologic methods such as microscopy, smear, and culture have low sensitivity, subjectivity, and contamination, which can lead to missed or false detection and affect patient outcomes (Dahyot et al, 2017). It is very important for patients with pulmonary infections to identify the etiology and use accurate drugs, especially for patients with lung damage such as pneumoconiosis.…”