Centre for Microbial Diseases and Immunity Research, Department of Microbiology and Immunology, University of British Columbia, 2259 Lower Mall Research Station, Vancouver, BC, Canada, V6T 1Z4,
Curr Infect Dis Rep. 2013 Oct;15(5):372-9. doi: 10.1007/s11908-013-0350-4.
Early and appropriate antibiotic use is critical for the treatment of sepsis. In practice, however, early antibiotic administration is hampered by diagnostic uncertainty with regard to both early diagnosis of disease and delayed or absent microbiological results. The diagnostic uncertainty often persists into the later stages of sepsis when clinical response to antibiotic treatment is assessed. Blood culture, the current "gold standard" test for diagnosis of sepsis, is inadequate due to low sensitivity and delayed results. However, despite this, the technology remains entrenched in microbiology laboratories due to decades of accumulated experience with the technique. However, in recent years there has been increasing experience with testing based on polymerase chain reaction (PCR). As the technology continues to improve, PCR testing is becoming faster and more sensitive. Moreover, PCR technologies that quantify bacterial load may enable monitoring of response to treatment and susceptibility testing.
早期和适当的抗生素使用对于脓毒症的治疗至关重要。然而，在实践中，早期抗生素的应用受到疾病早期诊断和微生物学结果延迟或缺失的诊断不确定性的阻碍。在评估抗生素治疗的临床反应时，诊断的不确定性常常持续到脓毒症的后期阶段。血培养是目前脓毒症诊断的“金标准”检测方法，但由于其敏感性低和结果延迟，因此并不充分。然而，尽管如此，由于该技术积累了数十年的经验，它仍然在微生物学实验室中根深蒂固。然而，近年来，基于聚合酶链反应（PCR）的检测技术的应用经验越来越多。随着技术的不断改进，PCR 检测变得更快、更灵敏。此外，定量细菌负荷的 PCR 技术可以实现对治疗反应和药敏试验的监测。
