Vol.66 No.4 July 2018
Prognosis of diagnostic methods for the causative bacteria of pneumonia
1)Department of Respiratory Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyusyu city, Fukuoka, Japan
2)Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences
Abstract
Accurate information on the causative bacteria of pneumonia is an important consideration in clinical practice; however, it is difficult to judge whether or not a specific bacterium is among the true causative bacteria based on the ordinary sputum culture methods that are typically employed. Along with the development of rapid diagnostic methods for causative bacteria, antigen detection using immunochromatography and genetic testing are also conducted and covered by the insurance system; however, the advantages of these methods are restricted to specific bacterial species. On the other hand, in recent years, the microbiota of the lower respiratory tract of patients with respiratory diseases can now be investigated due to the emergence of next generation sequencing technology, which has facilitated the analysis of large numbers of base sequences within a short amount of time. In our facility, we examined the bacterial flora in the bronchial lavage fluid of patients with community acquired pneumonia, healthcare-associated pneumonia, and hospital acquired pneumonia using a combination of Sanger sequencing and the clone library method. In addition to the commonly-recognized causative bacteria, our investigation revealed that oral streptococci and anaerobic bacteria play a more important role than previously reported. In addition, we clarified that oral streptococci are often detected in elderly patients with poor general condition. We investigated whether MRSA and pseudomonas aeruginosa (multidrug resistant bacteria) are causative organisms or not; however, we demonstrated that the importance of these bacteria might be overestimated as causative bacteria are detected by culture methods.
Key word
pneumonia, causative pathogen, cultivation method, clone library analysis
Received
January 31, 2018
Accepted
February 6, 2018
Jpn. J. Chemother. 66 (4): 483-488, 2018