Sepsis biomarkers and pathogen detection methods: State of the art
Evidence-based blood culture testing is of utmost importance for ICU patients with suspected sepsis or organ infection. Knowledge of the etiologic agent (bacteria or fungi) and their susceptibility against antimicrobials enables the clinician to initiate an appropriate antimicrobial therapy and guid...
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| Format: | Article |
| Language: | English |
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Association of medical doctors Sanamed Novi Pazar
2014-01-01
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| Series: | Sanamed |
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| Online Access: | http://sanamed.rs/sanamed_pdf/sanamed_9_1/Roland_Schmitz.pdf |
| _version_ | 1797282645451735040 |
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| author | Schmitz Roland P.H. Brunkhorst Frank M. |
| author_facet | Schmitz Roland P.H. Brunkhorst Frank M. |
| author_sort | Schmitz Roland P.H. |
| collection | DOAJ |
| description | Evidence-based blood culture testing is of utmost importance for ICU patients with suspected sepsis or organ infection. Knowledge of the etiologic agent (bacteria or fungi) and their susceptibility against antimicrobials enables the clinician to initiate an appropriate antimicrobial therapy and guides diagnostic procedures. This has been shown to reduce mortality, ICU-stay and antibiotic overuse. Whereas microbiological laboratory practice has been highly standardized, shortfalls in the preanalytic procedures in the ICU (indication, timing, volume, numbers, collection of blood cultures) have a significant effect on the diagnostic yield. Due to system-related drawbacks of molecular diagnostics, i.e. PCR-based pathogen detection, which are arguable sensitivities, the failing of the 'fast time-to-result argument', no solution to establish a comprising antibiogram, still ongoing discussions on the coverage of the target panel, high overall costs, and the lacking of resilient data on clinical utility, non-culture-based NATs do currently not represent an alternative to blood culture testing. Inflammatory markers are recognized to play an increasingly important role in the diagnosis and monitoring of sepsis. This is partly due to low specificity of clinical symptoms and conventional inflammatory signs for the diagnosis of sepsis but also to a lack of correlation with the severity of the inflammatory response. Elevated serum PCT levels indicate systemic inflammation reliably. PCT is the only sepsis marker that is helpful in the differentiation between infectious and non-infectious causes of organ dysfunction and shock and might support antibiotic therapy. |
| first_indexed | 2024-03-07T17:17:25Z |
| format | Article |
| id | doaj.art-b5297a08081b4e00a64292b61880bba6 |
| institution | Directory Open Access Journal |
| issn | 1452-662X 2217-8171 |
| language | English |
| last_indexed | 2024-03-07T17:17:25Z |
| publishDate | 2014-01-01 |
| publisher | Association of medical doctors Sanamed Novi Pazar |
| record_format | Article |
| series | Sanamed |
| spelling | doaj.art-b5297a08081b4e00a64292b61880bba62024-03-02T22:00:52ZengAssociation of medical doctors Sanamed Novi PazarSanamed1452-662X2217-81712014-01-0191496110.5937/sanamed1401049SSepsis biomarkers and pathogen detection methods: State of the artSchmitz Roland P.H.0Brunkhorst Frank M.1Paul-Martini Research Group, Jena University Hospital, GermanyPaul-Martini Research Group, Jena University Hospital, Germany + Center for Clinical Studies (ZKS), Center of Sepsis Control and Care (CSCC), Jena University Hospital, GermanyEvidence-based blood culture testing is of utmost importance for ICU patients with suspected sepsis or organ infection. Knowledge of the etiologic agent (bacteria or fungi) and their susceptibility against antimicrobials enables the clinician to initiate an appropriate antimicrobial therapy and guides diagnostic procedures. This has been shown to reduce mortality, ICU-stay and antibiotic overuse. Whereas microbiological laboratory practice has been highly standardized, shortfalls in the preanalytic procedures in the ICU (indication, timing, volume, numbers, collection of blood cultures) have a significant effect on the diagnostic yield. Due to system-related drawbacks of molecular diagnostics, i.e. PCR-based pathogen detection, which are arguable sensitivities, the failing of the 'fast time-to-result argument', no solution to establish a comprising antibiogram, still ongoing discussions on the coverage of the target panel, high overall costs, and the lacking of resilient data on clinical utility, non-culture-based NATs do currently not represent an alternative to blood culture testing. Inflammatory markers are recognized to play an increasingly important role in the diagnosis and monitoring of sepsis. This is partly due to low specificity of clinical symptoms and conventional inflammatory signs for the diagnosis of sepsis but also to a lack of correlation with the severity of the inflammatory response. Elevated serum PCT levels indicate systemic inflammation reliably. PCT is the only sepsis marker that is helpful in the differentiation between infectious and non-infectious causes of organ dysfunction and shock and might support antibiotic therapy.http://sanamed.rs/sanamed_pdf/sanamed_9_1/Roland_Schmitz.pdfBlood stream infectionblood culturessepsisguidelinesantimicrobial therapymolecular diagnostics |
| spellingShingle | Schmitz Roland P.H. Brunkhorst Frank M. Sepsis biomarkers and pathogen detection methods: State of the art Sanamed Blood stream infection blood cultures sepsis guidelines antimicrobial therapy molecular diagnostics |
| title | Sepsis biomarkers and pathogen detection methods: State of the art |
| title_full | Sepsis biomarkers and pathogen detection methods: State of the art |
| title_fullStr | Sepsis biomarkers and pathogen detection methods: State of the art |
| title_full_unstemmed | Sepsis biomarkers and pathogen detection methods: State of the art |
| title_short | Sepsis biomarkers and pathogen detection methods: State of the art |
| title_sort | sepsis biomarkers and pathogen detection methods state of the art |
| topic | Blood stream infection blood cultures sepsis guidelines antimicrobial therapy molecular diagnostics |
| url | http://sanamed.rs/sanamed_pdf/sanamed_9_1/Roland_Schmitz.pdf |
| work_keys_str_mv | AT schmitzrolandph sepsisbiomarkersandpathogendetectionmethodsstateoftheart AT brunkhorstfrankm sepsisbiomarkersandpathogendetectionmethodsstateoftheart |