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Curr Opin Infect Dis

Title:		New diagnostic methods for pneumonia in the ICU
Author(s):		Douglas IS;
Address:		"Pulmonary Sciences and Critical Care Medicine, Denver Health Medical Center, Denver and University of Colorado, School of Medicine, Aurora, Colorado, USA"
Journal Title:		Curr Opin Infect Dis
Year:		2016
Volume:		29
Issue:		2
Page Number:		197 - 204
DOI:		10.1097/QCO.0000000000000249
ISSN/ISBN:		1473-6527 (Electronic) 0951-7375 (Linking)
Abstract:		"PURPOSE OF REVIEW: Pneumonia leading to severe sepsis and critical illness including respiratory failure remains a common and therapeutically challenging diagnosis. Current clinical approaches to surveillance, early detection, and conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of community-acquired and health care-acquired pneumonia, including ventilator-associated pneumonia (VAP), are the focus of recent studies reviewed here. RECENT FINDINGS: Newer surveillance definitions are sensitive for pneumonia in the ICU including VAP but consistently underdetect patients that are clinically shown to have bacterial VAP based on clinical diagnostic criteria and response to antibiotic treatment. Routinely measured plasma biomarkers, including procalcitonin and C-reactive protein, lack sufficient precision and predictive accuracy to inform diagnosis. Novel rapid microbiological diagnostics, including nucleic-acid amplification, mass spectrometry, and fluorescence microscopy-based technologies are promising approaches for the future. Exhaled breath biomarkers, including measurement of volatile organic compounds, represent a future approach. SUMMARY: The integration of novel diagnostics for rapid microbial identification, resistance phenotyping, and antibiotic sensitivity testing into usual care practice could significantly transform the care of patients and potentially inform significantly improved targeted antimicrobial selection, de-escalation, and stewardship"
Keywords:		Biomarkers/analysis Breath Tests/methods Community-Acquired Infections/diagnosis Cross Infection/diagnosis Humans Intensive Care Units Microbiological Techniques/*methods/trends Molecular Diagnostic Techniques/*methods/trends Pneumonia/*diagnosis;
Notes:		"MedlineDouglas, Ivor S eng Review 2016/02/10 Curr Opin Infect Dis. 2016 Apr; 29(2):197-204. doi: 10.1097/QCO.0000000000000249"