Document Detail


Why should we measure bacterial load when treating community-acquired pneumonia?
MedLine Citation:
PMID:  21301334     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: We focus on a number of studies in the past 2 years that herald a dramatic shift in how we treat patients with not just community-acquired pneumonia (CAP), but potentially all sepsis.
RECENT FINDINGS: Recent studies report that high bacterial load, and specifically pneumococcal load in CAP, appears to be significantly associated with worse outcomes. These findings change the sepsis paradigm. Bacterial load may identify potential candidates for adjunctive therapy, ICU admission and more aggressive management.
SUMMARY: Whereas we all acknowledge the importance of the virulence of the pathogen in the outcome of CAP, microbiological tests currently play little role in management of patients. Whereas molecular tests such as polymerase chain reaction have promised to deliver accurate results in a clinically useful period of time, apart from a few niche situations they have yet to enter routine practice. In particular the ability to calculate the bacterial load in blood, and specifically pneumococcal load in CAP, appears to have significant clinical utility. Not only does bacterial load predict clinical outcome, the data so far available challenge some of our fundamental assumptions about optimal antibiotic therapy and the pathogenesis of severe sepsis.
Authors:
Grant Waterer; Jordi Rello
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in infectious diseases     Volume:  24     ISSN:  1473-6527     ISO Abbreviation:  Curr. Opin. Infect. Dis.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-02-24     Completed Date:  2011-04-06     Revised Date:  2012-01-31    
Medline Journal Info:
Nlm Unique ID:  8809878     Medline TA:  Curr Opin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  137-41     Citation Subset:  IM    
Affiliation:
School of Medicine and Pharmacology, Royal Perth Hospital, University of Western Australia, Perth, Western Australia, Australia.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Bacterial Load*
Community-Acquired Infections / diagnosis,  drug therapy,  microbiology*
Humans
Pneumonia, Bacterial / diagnosis,  drug therapy,  microbiology*
Pneumonia, Pneumococcal / diagnosis,  drug therapy,  microbiology
Polymerase Chain Reaction
Prognosis
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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