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. 2019 Jul;17(7):523-533.
doi: 10.1080/14787210.2019.1635010. Epub 2019 Jun 25.

Emerging Strategies for the Noninvasive Diagnosis of Nosocomial Pneumonia

Free PMC article

Emerging Strategies for the Noninvasive Diagnosis of Nosocomial Pneumonia

Adamantia Liapikou et al. Expert Rev Anti Infect Ther. .
Free PMC article


Introduction: Hospital-acquired pneumonia is a common and therapeutically challenging diagnosis that can lead to severe sepsis, critical illness, and respiratory failure. In this review, we focus on efforts to enhance microbiological diagnosis of hospital-acquired pneumonia, including ventilator-associated pneumonia. Areas covered: A systematic literature review was conducted by searching Medline from inception to December 2018, including hand-searching of the reference lists for additional studies. The search strategy comprised the following common search terms: hospital pneumonia OR nosocomial pneumonia OR noninvasive OR molecular diagnostic tests (OR point-of-care systems OR VOC [i.e. volatile organic compounds]) OR rapid (or simple or quick test), including brand names for the most common commercial tests. Expert opinion: In recent years, the microbiological diagnosis of respiratory pathogens has improved significantly by the development and implementation of molecular diagnostic tests for pneumonia. Real-time polymerase chain reaction, hybridization, and mass spectrometry-based platforms dominate the scene, with microarray-based assays, multiplex polymerase chain reaction, and MALDI-TOF mass spectrometry capable of detecting the determinants of antimicrobial resistance (mainly β-lactamase genes). Introducing these assays into routine clinical practice for rapid identification of the causative microbes and their resistance patterns could transform the care of pneumonia, improving antimicrobial selection, de-escalation, and stewardship.

Keywords: Nosocomial pneumonia; VOC; diagnosis; mass spectrometry; molecular; noninvasive.

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This study was supported by Centro de Investigaciones biomedicas En Red-Enfermedades Respiratorias (CibeRes CB06/06/0028)-ISCIII, Barcelona, Spain, and 2009 Support to Research Groups of Catalonia 911; IDIBAPS.