Microbiological Diagnosis of Chest Infection Flashcards
What diagnostic techniques are used for chest infections?
- Microscopy and culture of blood and sputum
- Antigen detection methods
- Nucleic acid amplification (PCR)
- Serology (antibody measurement)
How valuable is gram staining for organisms and pus cells?
Limited value
What are the 3 major respiratory pathogens?
- Strep pneumoniae
- Hameophilius influenzae
- Moraxella Catarrhalis
What may you expect to find in sputum cultures?
Normal upper respiratory flora such as viridans streps
What does previous antibiotic therapy select out?
Organisms that are not respiratory pathogens such as:
- E. coli
- Staph aureus
How must sputum cultures be interpreted?
Using the clinical presentation:
- Community pneumonia
- Aspiration pneumonia
- Ventilated patient pneumonia
How is TB diagnosed?
Using ZN or auramine phenol stain
How is TB described?
Acid and Alcohol Fast Bacilli (AAFB)
How is a broncho-alveolar lavage done?
- Lower airway sample collected at bronchoscopy
- Catheter aspirate in ventilated patient
What is BAL used in the diagnosis of?
Ventilator associated pneumonia
What is an advantaged of BAL?
Less liable to contamination- more accurate diagnosis of LRTI
What does BAL produce?
Quantitative culture of BAL- colony forming units/ml (cfu/ml)
Who are blood cultures taken from?
Any patient with severe sepsis
What do many patients with pneumonia have in their blood?
Bacteraemia (viable bacteria in the blood)
Why is blood culture carried out?
There are too few organisms in blood to see on microscopy
How is blood culture carried out?
Blood inoculated into 2 bottle containing culture media and incubated
What happens on day 1 of blood culture?
- Microscopy positive in 6-48 hours (Gram stain)
- Result is phoed to the clinician and interim recommendations on antibiotics
- Overnight subculture of sensitivity and identification tests
What happens on day 2 of blood culture?
-Full ID and sens- clinical significance is re-assessed
What organisms are not easily cultured and are known as atypical causes?
- Legionella pneumophila
- Mycoplasma pneumoniae
- Chlamydia psittaci
- Coxiella burnetti