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Review
. 2006 Nov-Dec;36(11-12):570-98.
doi: 10.1016/j.medmal.2006.07.008. Epub 2006 Nov 13.

[Contribution of microbiological investigations to the diagnosis of lower respiratory tract infections]

[Article in French]
O Leroy  1
Affiliations
Review

[Contribution of microbiological investigations to the diagnosis of lower respiratory tract infections]

[Article in French]
O Leroy. Med Mal Infect. 2006 Nov-Dec.

Abstract
in English, French

The diagnosis of community-acquired pneumonia is usually based on clinical and radiological criteria. The identification of a causative organism is not required for the diagnosis. Although numerous microbiological techniques are available, their sensitivity and specificity are not high enough to guide first-line antimicrobial therapy. Consequently, this treatment remains most often empiric. If the causative organism is identified, the antimicrobial treatment is adapted. Sputum analysis may be proposed as a diagnostic tool for patients with an acute exacerbation of chronic obstructive pulmonary disease, in specific cases (prior antibiotherapy, hospitalization, failure of the empiric antimicrobial treatment).

Les critères usuels du diagnostic positif d'une pneumonie aiguë communautaire sont cliniques et radiologiques. La confirmation microbiologique de l'infection n'est donc pas nécessaire au diagnostic. Malgré la multiplicité des techniques microbiologiques actuellement disponibles, aucune n'a suffisamment de sensibilité et de spécificité pour influencer l'antibiothérapie initiale qui demeure donc le plus souvent probabiliste. En cas de documentation microbiologique positive, une adaptation secondaire du traitement peut toutefois être envisagée. Au cours des exacerbations aiguës des bronchopneumopathies chroniques obstructives, le seul examen utile est l'analyse cytobactériologique des sécrétions bronchiques qui sera réalisée dans certaines circonstances (antibiothérapie antérieure, hospitalisation, échec du traitement probabiliste).

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