Department of Anesthesiology and Intensive Care, Friedrich Schiller University Hospital, Erlanger Allee 101, 07743, Jena, Germany,
Curr Infect Dis Rep. 2010 Sep;12(5):329-35. doi: 10.1007/s11908-010-0122-3.
Early diagnosis is crucial to reduce morbidity and mortality from sepsis. Clinical suspicion is the first step to diagnosis, and necessitates meticulous history taking and complete clinical examination. Special attention should be paid to identifying foci of infection. Biomarkers of host response-including acute phase proteins, procalcitonin, and various cytokines-may be useful in the diagnosis and management of patients with sepsis. Rapid and reliable detection of pathogens and their antibiotic susceptibility patterns is also of utmost importance. Many new techniques have been developed to shorten the time required for pathogen detection, including nucleic acid-based technologies (eg, polymerase chain reaction, microarrays, and hybridization). The detection of pathogen-related antigens is another approach that is useful in the diagnosis of fungal infections, targeting fungal cell wall components such as galactomannan and (1→3)-β-D-glucan.
早期诊断对于降低脓毒症的发病率和死亡率至关重要。临床怀疑是诊断的第一步,需要仔细采集病史和进行全面的临床检查。特别要注意识别感染灶。宿主反应的生物标志物——包括急性期蛋白、降钙素原和各种细胞因子——在脓毒症患者的诊断和治疗中可能有用。快速可靠地检测病原体及其抗生素敏感性模式也非常重要。许多新技术已被开发出来以缩短病原体检测所需的时间,包括基于核酸的技术(例如聚合酶链反应、微阵列和杂交)。病原体相关抗原的检测是另一种有用的真菌感染诊断方法,针对真菌细胞壁成分,如半乳甘露聚糖和(1→3)-β-D-葡聚糖。