SHOULD QUANTITATIVE CULTURES BE ROUTINELY USED IN DIAGNOSTIC WORK-UP OF PNEUMONIA

Quantitative cultures of respiratory secretions represent a valid tech nique for the diagnosis of ventilator-associated pneumonia. Contaminat ion, colonization and true infection can be differentiated with a reas onable specificity using established cut-on; of bacterial colony count s. Quantitative investigations provide local epidemiological databases as a framework for empirical antimicrobial policies and may also prov e helpful in the guidance of individual antimicrobial therapy. Another reasonable indication is HIV-associated pneumonia. However, the use o f this technique in routine practice is hampered by the high expertise and experience that will be necessary to be sucessfully used. Neverth eless, in view of the need to identify bacterial susceptibility patter ns, at least large treatment centers should routinely use this most po werful diagnostic technique.