Infektionsdiagnostik in der Pneumologie

Zusammenfassung

Untere Atemwegsinfektionen gehören weltweit zu den häufigsten Erkrankungen und Todesursachen. Im klinischen Alltag, insbesondere bei der Betreuung schwer kranker Patienten, stellt die Unterscheidung zwischen einer tracheobronchialen Kolonisation von Mikroorganismen und einer behandlungsbedürftigen Infektion eine Herausforderung dar. Während die rasche Einleitung einer antibiotischen Therapie bei schwer kranken Patienten von entscheidender prognostischer Bedeutung ist, stellt der inadäquate Gebrauch von Antibiotika eine wichtige Ursache von Resistenzbildungen dar. Im ersten Teil der Arbeit wurden Methoden zur Infektionsdiagnostik bei tiefen Atemwegserkrankungen detailliert vorgestellt. Der hier vorliegende zweite Teil der Übersicht behandelt Methoden und Kriterien zur Unterscheidung von bakterieller Kolonisation und Infektion im Rahmen von tiefen Atemwegsinfektionen durch klinisch relevante Mikroorganismen.

Abstract

Lower respiratory tract infections rank among the leading causes of morbidity and mortality worldwide. In clinical practice, especially in the care of severely ill patients, discrimination between tracheobronchial colonisation with potentially pathogenic microorganisms and infection is a common diagnostic challenge. While prompt antibiotic treatment is needed in critically ill patients with pneumonia, an inadequate use of antibiotics is the major cause for the emergence of drug-resistant microorganisms. The first part of this review provided a detailed overview of the currently available methods for the diagnosis of pulmonary infectious diseases. In the present second part of the manuscript, we focus upon methods and criteria for the differentiation between lower respiratory tract bacterial colonisation and lower respiratory tract infections, highlighting important pathogens.

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