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Diagnostics
Special Issues
Diagnosing Pneumonia: Challenges and Advances
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Diagnosing Pneumonia: Challenges and Advances

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 17804

Special Issue Editor

Prof. Dr. Xinlun Tian

E-Mail Website
Guest Editor
Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
Interests: infectious diseases in lung; bronchiectasis and rare lung diseases

Special Issue Information

Dear Colleagues, 

Pneumonia is an ancient disease, but today, despite the rapid development of molecular biology techniques, many unrecognized areas remain. The diagnosis of pneumonia seems simple and intuitive based on rapid radiological tools; however, distinguishing pneumonia from non-infectious diseases remains challenging. Although microbiological results provide evidence for diagnosis, long turnaround times and high false-negative rates impede timely diagnoses and personalized therapies. Recent advances in molecular technologies for pathogen detection have significantly expanded our understanding of the different etiologies of pneumonia; the utilization of omics based on similar technique modules have made accurate and differential diagnoses more accessible, and have shed light on the underlying pathological mechanisms. The progress we have made has improved the clinical understanding, handling and prognosis of pneumonia. However, the gap between bench and bedside remains, and bridging the gap between research and clinical practice remains urgent. Therefore, we wholeheartedly invite global practitioners and investigators to submit original research articles, review articles, and case reports to our Special Issue. We welcome the submission of research that seeks to address state-of-the-art techniques and methodologies for developing the research and management of pneumonia.

Potential topics include, but are not limited to, the following:

  • Novel diagnostic strategies;
  • Prognosis prediction tools;
  • Novel or newly introduced biomarkers;
  • Next-generation sequencing approaches;
  • Multiple omics.

Prof. Dr. Xinlun Tian
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pneumonia
  • predictive biomarkers
  • diagnostic methods
  • molecular tests
  • individualized treatment

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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14 pages, 1912 KiB  
Article
Predictive Value of Annenxin A1 for Disease Severity and Prognosis in Patients with Community-Acquired Pneumonia
by Minghao Gu, Xiudi Han, Xuedong Liu, Fengxiang Sui, Quansan Zhang and Shengqi Pan
Diagnostics 2023, 13(3), 396; https://doi.org/10.3390/diagnostics13030396 - 21 Jan 2023
Cited by 3 | Viewed by 2011
Abstract
This prospective, single-center study evaluated the clinical utility of annenxin (Anx)A1 level as a biomarker for determining the severity of illness and predicting the risk of death in hospitalized patients with community-acquired pneumonia (CAP). A total of 105 patients (53 with severe [S]CAP, [...] Read more.
This prospective, single-center study evaluated the clinical utility of annenxin (Anx)A1 level as a biomarker for determining the severity of illness and predicting the risk of death in hospitalized patients with community-acquired pneumonia (CAP). A total of 105 patients (53 with severe [S]CAP, 52 with non-SCAP) were enrolled from December 2020 to June 2021. Demographic and clinical data were recorded. Serum AnxA1 concentration on days one and six after admission was measured by enzyme-linked immunosorbent assay. AnxA1 level at admission was significantly higher in SCAP patients than in non-SCAP patients (p < 0.001) irrespective of CAP etiology and was positively correlated with Pneumonia Severity Index and Confusion, Uremia, Respiratory Rate, Blood Pressure, and Age ≥ 65 Years score. AnxA1 level was significantly lower on day six after treatment than on day one (p = 0.01). Disease severity was significantly higher in patents with AnxA1 level ≥254.13 ng/mL than in those with a level <254.13 ng/mL (p < 0.001). Kaplan–Meier analysis of 30-day mortality showed that AnxA1 level ≤670.84 ng/mL was associated with a significantly higher survival rate than a level >670.84 ng/mL. These results indicate that AnxA1 is a useful biomarker for early diagnosis and prognostic assessment of CAP. Full article
(This article belongs to the Special Issue Diagnosing Pneumonia: Challenges and Advances)
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11 pages, 868 KiB  
Article
The Clinical Impact of Metagenomic Next-Generation Sequencing (mNGS) Test in Hospitalized Patients with Suspected Sepsis: A Multicenter Prospective Study
by Yi-Hui Zuo, Yi-Xing Wu, Wei-Ping Hu, Yan Chen, Yu-Ping Li, Zhen-Ju Song, Zhe Luo, Min-Jie Ju, Min-Hua Shi, Shu-Yun Xu, Hua Zhou, Xiang Li, Zhi-Jun Jie, Xue-Dong Liu and Jing Zhang
Diagnostics 2023, 13(2), 323; https://doi.org/10.3390/diagnostics13020323 - 16 Jan 2023
Cited by 11 | Viewed by 3602
Abstract
Background: Metagenomic Next Generation Sequencing (mNGS) has the potential to detect pathogens rapidly. We aimed to assess the diagnostic performance of mNGS in hospitalized patients with suspected sepsis and evaluate its role in guiding antimicrobial therapy. Methods: A multicenter, prospective cohort study was [...] Read more.
Background: Metagenomic Next Generation Sequencing (mNGS) has the potential to detect pathogens rapidly. We aimed to assess the diagnostic performance of mNGS in hospitalized patients with suspected sepsis and evaluate its role in guiding antimicrobial therapy. Methods: A multicenter, prospective cohort study was performed. We enrolled patients with suspected sepsis, collected clinical characteristics and blood samples, and recorded the 30-day survival. Diagnostic efficacy of mNGS test and blood culture was compared, and the clinical impact of mNGS on antibiotic regimen modification was analyzed. Results: A total of 277 patients were enrolled, and 162 were diagnosed with sepsis. The mortality was 44.8% (121/270). The mNGS test exhibited shorter turn-out time (27.0 (26.0, 29.0) vs. 96.0 (72.0, 140.3) hours, p < 0.001) and higher sensitivity (90.5% vs. 36.0%, p < 0.001) compared with blood culture, especially for fungal infections. The mNGS test showed better performance for patients with mild symptoms, prior antibiotic use, and early stage of infection than blood culture, and was capable of guiding antibiotic regimen modification and improving prognosis. Higher reads of pathogens detected by mNGS were related to 30-day mortality (p = 0.002). Conclusions: Blood mNGS testing might be helpful for early etiological diagnosis of patients with suspected sepsis, guiding the antibiotic regimen modification and improving prognosis. Full article
(This article belongs to the Special Issue Diagnosing Pneumonia: Challenges and Advances)
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13 pages, 1210 KiB  
Article
Prognostic Analysis of Pneumocystis Jirovecii Pneumonia in Interstitial Lung Disease Patients: A Retrospective Clinical Study
by Yuxin Sun, Chi Shao, Hui Huang, Ruxuan Chen, Kai Xu, Mei Li, Xin Zhang and Zuojun Xu
Diagnostics 2022, 12(12), 2925; https://doi.org/10.3390/diagnostics12122925 - 23 Nov 2022
Cited by 4 | Viewed by 2089
Abstract
(1) Background: The clinical characteristics and the prognostic factors of HIV-negative Pneumocystis jirovecii pneumonia (PJP) patients (non-HIV-PJP) with interstitial lung disease (ILD) remain unclear. Our objectives were to describe the clinical characteristics and to explore the prognostic factors of non-HIV-ILD-PJP patients. (2) Methods: [...] Read more.
(1) Background: The clinical characteristics and the prognostic factors of HIV-negative Pneumocystis jirovecii pneumonia (PJP) patients (non-HIV-PJP) with interstitial lung disease (ILD) remain unclear. Our objectives were to describe the clinical characteristics and to explore the prognostic factors of non-HIV-ILD-PJP patients. (2) Methods: The enrolled patients in this retrospective study were stratified based on the presence or absence of ILD and fibrotic ILD (FILD). The log-rank test and Cox regression models were used to analyze the prognostic factors. (3) Results: Among 378 non-HIV-PJP patients, there were 133 patients with ILD-PJP, and 70 patients were classified as having FILD-PJP. The all-cause mortality rate for the ILD-PJP group is higher than that of the ILD-PJP group (57.9% vs. 38.4%, p < 0.001). However, the all-cause mortality is similar between the FILD-PJP group and non-FILD-PJP group. Preexisting ILD (HR: 2.156, p = 0.003) and honeycomb appearance on the chest HRCT (HR = 16.3, p < 0.001) are independent survival risk factors for ILD-PJP. Non-invasive ventilation is an independent survival risk factor for ILD-PJP patients (HR = 928.56, p < 0.01) and FILD-PJP patients (HR = 33.86, p < 0.001). (4) Conclusions: Pre-existing ILD and honeycomb appearance on the chest HRCT are independent survival risk factors for PJP patients. Non-invasive ventilation is associated with poor survival for both ILD-PJP and FILD-PJP patients. Full article
(This article belongs to the Special Issue Diagnosing Pneumonia: Challenges and Advances)
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Review

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16 pages, 734 KiB  
Review
Clinical and Laboratory Diagnosis of Legionella Pneumonia
by Lu Bai, Wei Yang and Yuanyuan Li
Diagnostics 2023, 13(2), 280; https://doi.org/10.3390/diagnostics13020280 - 12 Jan 2023
Cited by 13 | Viewed by 9084
Abstract
Legionella pneumonia is a relatively rare but extremely progressive pulmonary infection with high mortality. Traditional cultural isolation remains the gold standard for the diagnosis of Legionella pneumonia. However, its harsh culture conditions, long turnaround time, and suboptimal sensitivity do not meet the clinical [...] Read more.
Legionella pneumonia is a relatively rare but extremely progressive pulmonary infection with high mortality. Traditional cultural isolation remains the gold standard for the diagnosis of Legionella pneumonia. However, its harsh culture conditions, long turnaround time, and suboptimal sensitivity do not meet the clinical need for rapid and accurate diagnosis, especially for critically ill patients. So far, pathogenic detection techniques including serological assays, urinary antigen tests, and mass spectrometry, as well as nucleic acid amplification technique, have been developed, and each has its own advantages and limitations. This review summarizes the clinical characteristics and imaging findings of Legionella pneumonia, then discusses the advances, advantages, and limitations of the various pathogenetic detection techniques used for Legionella pneumonia diagnosis. The aim is to provide rapid and accurate guiding options for early identification and diagnosis of Legionella pneumonia in clinical practice, further easing healthcare burden. Full article
(This article belongs to the Special Issue Diagnosing Pneumonia: Challenges and Advances)
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