Pneumologie 2010; 64(5): 291-299
DOI: 10.1055/s-0029-1243917
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Infektionsdiagnostik in der Pneumologie

Teil 2: Nachweis von bakteriellen Mikroorganismen aus dem Tracheobronchialsystem: Infektion oder Kolonisation?Diagnosis of Infections in PneumologyPart II: Detection of Bacterial Microorganisms from the Tracheobronchial System: Infection or Colonisation?A.  Strassburg1 , K.  Dalhoff2 , I.  Engelmann3 , S.  Ewig4 , F.  J.  F.  Herth5 , J.  Knobloch6 , G.  Rohde7 , H.  Sahly8 , B.  Schaaf9 , C.  Lange1
  • 1Klinische Infektiologie, Medizinische Klinik, Forschungszentrum Borstel
  • 2Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
  • 3Institut für Virologie, Medizinische Hochschule Hannover; aktuelle Adresse: Centre d’Immunologie de Marseille-Luminy, Université de la Méditerranée, Marseille, France
  • 4Thoraxzentrum Ruhrgebiet, Kliniken für Pneumologie und Infektiologie, EVK Herne und Augusta-Kranken-Anstalt Bochum
  • 5Thoraxklinik am Universitätsklinikum Heidelberg, Pneumologie und Beatmungsmedizin
  • 6Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
  • 7Medizinische Klinik III, Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Bochum
  • 8Institut für Infektionsmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, und IPM-Biotech, Labor Lademannbogen, Hamburg
  • 9Medizinische Klinik Nord, Pneumologie und Infektiologie, Klinikum Dortmund, Dortmund
Weitere Informationen

Publikationsverlauf

eingereicht 11.1.2010

akzeptiert 12.1.2010

Publikationsdatum:
07. Mai 2010 (online)

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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Prof. Dr. med. Dipl.-Biol. Christoph Lange

Klinische Infektiologie, Medizinische Klinik
Forschungszentrum Borstel

Parkallee 35
23845 Borstel

eMail: clange@fz-borstel.de