Aktuelle Konzepte zum mikrobiologischen Nachweis von Atemwegserregern

Zusammenfassung

Die Häufigkeit und das Spektrum bakterieller Erreger bei Atemwegsinfektionen sind von einer Vielzahl von Variablen abhängig. Die Epidemiologie wird entscheidend durch die Art der zugrunde liegenden Atemwegsinfektionen, die Abwehrlage des Patienten, geographische und saisonale Faktoren und den Umfang und die Auswahl der eingesetzten diagnostischen Methoden beeinflusst. Darüber hinaus ist die klinische Bedeutung eines positiven Erregernachweises aus respiratorischen Sekreten unsicher, da es sich um unsterile oder kontaminierte Materialien handelt. Die ätiologische Relevanz erschließt sich somit erst aus der synoptischen Beurteilung der mikrobiologischen und klinischen Daten, wobei der Einschätzung einer Immunsuppression oder lokalen Abwehrstörung eines Patienten hierbei eine wichtige Rolle zukommt.

Abstract

The frequency and range of bacterial pathogens in respiratory tract infections depends on a variety of variables. The aetiology is influenced by the type of respiratory tract infection (acute bronchitis, acute exacerbation of chronic bronchitis, community-acquired pneumonia, nosocomial pneumonia), geographic and seasonal factors, and by the diagnostic methods implemented to identify the pathogens. Furthermore, there exists a considerable uncertainty concerning the clinical relevance of positive bacteriological findings in respiratory secretions because they are retrieved from non-sterile or contaminated environments. To differentiate infection from contamination, both microbiological and clinical findings have to be assessed, which might be difficult in the setting of systemic or local immunosuppression.

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Bisher erschienene Beiträge dieser Serie

• 60 Strassburg A. et al . Infektionsdiagnostik in der Pneumologie.  Pneumologie. 2008;  62 730-743
• 61 Rohde G. et al . Nachweis von Atemwegsviren – wie, warum, wann und wo?.  Pneumologie. 2009;  63 14-22
• 62 Gillissen A. et al . Biomarker bei infektiösen und nicht infektiösen Lungenerkrankungen außer Malignome.  Pneumologie. 2009;  63 439-450