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Rutenberg D, Zhang Y, Montoya JG, Sinnott J, Contopoulos-Ioannidis DG. The Meat of the Matter. N Engl J Med 2024; 390:1612-1618. [PMID: 38692295 DOI: 10.1056/nejmcps2311297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Affiliation(s)
- David Rutenberg
- From the Department of Medicine, Division of Infectious Disease and International Medicine, Morsani College of Medicine, University of South Florida (D.R., Y.Z., J.S.), and the Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute (Y.Z.) - both in Tampa; and the Dr. Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto Medical Foundation, Palo Alto (J.G.M., D.G.C.-I.), and the Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford (D.G.C.-I.) - both in California
| | - Yumeng Zhang
- From the Department of Medicine, Division of Infectious Disease and International Medicine, Morsani College of Medicine, University of South Florida (D.R., Y.Z., J.S.), and the Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute (Y.Z.) - both in Tampa; and the Dr. Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto Medical Foundation, Palo Alto (J.G.M., D.G.C.-I.), and the Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford (D.G.C.-I.) - both in California
| | - Jose G Montoya
- From the Department of Medicine, Division of Infectious Disease and International Medicine, Morsani College of Medicine, University of South Florida (D.R., Y.Z., J.S.), and the Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute (Y.Z.) - both in Tampa; and the Dr. Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto Medical Foundation, Palo Alto (J.G.M., D.G.C.-I.), and the Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford (D.G.C.-I.) - both in California
| | - John Sinnott
- From the Department of Medicine, Division of Infectious Disease and International Medicine, Morsani College of Medicine, University of South Florida (D.R., Y.Z., J.S.), and the Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute (Y.Z.) - both in Tampa; and the Dr. Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto Medical Foundation, Palo Alto (J.G.M., D.G.C.-I.), and the Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford (D.G.C.-I.) - both in California
| | - Despina G Contopoulos-Ioannidis
- From the Department of Medicine, Division of Infectious Disease and International Medicine, Morsani College of Medicine, University of South Florida (D.R., Y.Z., J.S.), and the Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute (Y.Z.) - both in Tampa; and the Dr. Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto Medical Foundation, Palo Alto (J.G.M., D.G.C.-I.), and the Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford (D.G.C.-I.) - both in California
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Pickens CI, Gao CA, Morales-Nebreda L, Wunderink RG. Microbiology of Severe Community-Acquired Pneumonia and the Role of Rapid Molecular Techniques. Semin Respir Crit Care Med 2024; 45:158-168. [PMID: 38196061 DOI: 10.1055/s-0043-1777770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
The microbiology of severe community acquired pneumonia (SCAP) has implications on management, clinical outcomes and public health policy. Therefore, knowledge of the etiologies of SCAP and methods to identify these microorganisms is key. Bacteria including Streptococcus pneumoniae, Staphylococcus aureus and Enterobacteriaceae continue to be important causes of SCAP. Viruses remain the most commonly identified etiology of SCAP. Atypical organisms are also important etiologies of SCAP and are critical to identify for public health. With the increased number of immunocompromised individuals, less common pathogens may also be found as the causative agent of SCAP. Traditional diagnostic tests, including semi-quantitative respiratory cultures, blood cultures and urinary antigens continue to hold an important role in the evaluation of patients with SCAP. Many of the limitations of the aforementioned tests are addressed by rapid, molecular diagnostic tests. Molecular diagnostics utilize culture-independent technology to identify species-specific genetic sequences. These tests are often semi-automated and provide results within hours, which provides an opportunity for expedient antibiotic stewardship. The existing literature suggests molecular diagnostic techniques may improve antibiotic stewardship in CAP, and future research should investigate optimal methods for implementation of these assays into clinical practice.
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Affiliation(s)
- Chiagozie I Pickens
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Catherine A Gao
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Luisa Morales-Nebreda
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Richard G Wunderink
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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