[Community-acquired pneumonia: comparison of etiological diagnostic methods in clinical practice]

Comparison of different methods of community-acquired pneumonia (CAP) etiological diagnosis.

A total of 20 male and 10 females patients 21 to 75 years of age entered the trial. All of them had CAP running a non-severe course. Microbiological and molecular-genetic methods were used to examine the patients' sputum, blood serum serological tests were made to measure the level of IgM and IgG antibodies (AB) to Chlamydophila pneumoniae and Mycoplasma pneumoniae.

Pathogens were detected in 23 (76.7%) patients. Microbiological examination (MBE) detected monobacterial contamination in 19 patients, polymerase chain reaction (pCR) identified monobacterial infection in 10 patients, mixed bacterial infection in 5 and viral-bacterial mixed contamination in 4 patients. MBE provided 19 positive results, PCR - 30 ones. Serological examination detected IgM AB to Mycoplasma pneumoniae in 6 patients, sputum investigation with PCR detected the pathogen only in 2 patients. IgM AB to Chlamydophila pneumoniae were detected in 4 patients, PCR failed to detect infection agent.

Current etiological diagnosis can be made with the highest efficacy with combination of three methods: microbiological -for detection of bacterial pathogens (except atypical agents), molecular-genetic--for identification of both bacterial and viral pathogens and serological--for diagnosis of atypical pathogens.