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In our discussions with ministers of education, university professors, classroom teachers, students and parents, we found universal disdain for the amount and intensity of testing in what they call their "examination culture".
Pathogen identification rate of direct examination, culture, and MPCR in patients with confirmed pneumonia was compared.
Direct examination, culture, and MPCR were performed on BAL fluid of critically ill patients with pneumonia suspicion.
Table 3 Comparison of diagnosis provided by direct examination, culture, and MPCR Direct examination Culture MPCR + + + + n = 9 + + − n = 1 + − + n = 0 + − − n = 1 − + + n = 6 − + − n = 5 − − + n = 20 − − − n = 11 Total positive: 12 (23%) Total positive: 21 (40%) Total positive: 35 (66%)$,£53 53 patients with a final diagnosis of pneumonia.
Table 4 Pathogens identified by direct examination, culture, and/or MPCR according to previous administration of antibiotic therapy Pt Previous antibiotic therapy Direct exam Culture MPCR Other positive microbiological specimen Final identification 1 Yes 0 0 E. coli/P.
When patients had received recent antibiotic therapy prior to BAL, pathogen identification rate with MPCR was not modified (64%) and remained higher than with direct examination (15%, p <0.001) or culture (23%, p <0.001) (Figure 1). Figure 1 Identification rate (percentage) of pathogen provided by direct examination, culture, and multiplex PCR.
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Blood, non-induced sputum, and nasopharyngeal swabs were collected in each participant once within 48 h after hospital presentation for direct examination, cultures and molecular diagnostic.
Cases were diagnosed as sepsis or non-infective SIRS by clinical examination, cultures of the biological fluid, and imaging during a 7-day follow-up.
Since 1995 in Shanghai, all suspected pulmonary TB cases detected in general hospitals or community health centers were referred to a specialized TB hospital or TB clinic for further diagnostic tests, including sputum smear examinations, culture and chest radiography.
Current microbiological testing for pneumonia relies primarily upon blood cultures and microscopic examination and culture of tracheal/bronchoalveolar aspirates.
To our knowledge, there is no study assessing effect of prior antibiotherapy on direct examination, bacteriological culture and concordance of direct microscopy and culture.
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