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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

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Free PMC article

Emerging Strategies for the Noninvasive Diagnosis of Nosocomial Pneumonia

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

Abstract

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.
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