POSTĘPOWANIE W DIAGNOSTYCE BAKTERYJNYCH
ZAKAŻEŃ DOLNYCH DRÓG ODDECHOWYCH
Elżbieta Stefaniuk
Zakład Epidemiologii i Mikrobiologii Klinicznej Narodowego Instytutu Zdrowia Publicznego,
ul Chełmska 3 0/34, 00-725 Warszawa, tel (022) S41 33 67,
e-mail: estefaniuk@cls.edu.pl
Wpłynęło w styczniu 2006
1. Wstęp. 2. Etiologia zakażeń dolnych dróg oddechowych. 3. Diagnostyka laboratoryjna zakażeń dolnych dróg oddechowych. 3.1. Plwocina. 3.2. Materiały z dolnych dróg oddechowych pobierane z użyciem technik inwazyjnych. 3.3. Mocz. 3.4. Krew. 4. Podsumowanie
Bacteriological diagnostic of lower respiratory tract infections
Abstract: Infections of the lower respiratory tract, including bronchitis and pneumonia, are common causes of morbidity and mortality. The majority of the causative bacterial pathogens of lower respiratory tract infections can be detected on standard lab oratory media. Sputum is most commonly used for stains and cultures, and the sample should be transported to the laboratory as soon as possible and processed immediately upon receipt. Gram-stained smears of lower respiratory tract secretions provide rapid presumptive information to guide the initial selection of antimicrobial therapy for patients with acute bacterial pneumonia. Tracheal secretions should be considered comparable to sputum for analysis by stain and culture, with application of the same requirements for minimizing contamination and expediting transport and processing. Quantative bacterial cultures are recommended for specimens obtained by protected specimen brushings (PSB) and bronchoalveolar lavage (BAL). Two approaches for quantative culture are acceptable: the serial-dilution method and the calibrated-loop method. Blood cultures are generally indicated in serious lower respiratory tract infections requiring hospitalization, such as pneumonia. New immunochromatographic urinary antigen detection assays (or Legionella pneumophila and Streptococcus pneumoniae are easy and šuickto perform and have relatively high sensitivies and specificities.
1. Introduction. 2. Etiology of lower respiratory tract infections. 3. Laboratory diagnostic of lower respiratory tract infections. 3.1. Sputum. 3.2. Lower respiratory tract specimes collected by invasive techniques. 3.3. Urine. 3.4. Blood. 4. Conclusions
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