[Specific sampling of biological material in the diagnosis of nosocomial pneumonia]

Before deciding what biological material should be investigated to determine the aetiology of nosocomial pneumonia, we have to carefully examine the patient and study documentary material about earlier treatment, especially the duration of artificial ventilation. When exploring the aetiological agent of nosocomial pneumonia we should analyse the patient's sputum, hemoculture, pleural effusion, urine to detect antigens of Legionella pneumophila, indicate transparietal lung biopsy under CT control and in isolated cases also open lung biopsy. Of great value is the investigation of material obtained during bronchoscopy, especially an analysis of the bronchoalveolar fluid from bronchoalveolar lavage. The procedures to obtain such material should be carefully chosen. Results should be correctly interpreted following the assessment of all available information on the patient.