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评估多重聚合酶链反应用于肺部或腹部脓毒症重症监护患者病原体鉴定及治疗调整的随机对照临床试验。

Randomized controlled clinical trial evaluating multiplex polymerase chain reaction for pathogen identification and therapy adaptation in critical care patients with pulmonary or abdominal sepsis.

作者信息

Tafelski Sascha, Nachtigall Irit, Adam Thomas, Bereswill Stefan, Faust Jana, Tamarkin Andrey, Trefzer Tanja, Deja Maria, Idelevich Evgeny A, Wernecke Klaus-Dieter, Becker Karsten, Spies Claudia

机构信息

Department of Anaesthesiology and Intensive Care Medicine, Charité-Universitaetsmedizin Berlin, Berlin, Germany.

Institute for Microbiology and Hygiene Berlin, Charité-Universitaetsmedizin Berlin, Berlin, Germany.

出版信息

J Int Med Res. 2015 Jun;43(3):364-77. doi: 10.1177/0300060514561135. Epub 2015 Apr 24.

Abstract

OBJECTIVE

To determine whether a multiplex polymerase chain reaction (PCR)-based test could reduce the time required for initial pathogen identification in patients in an intensive care unit (ICU) setting.

METHODS

This double-blind, parallel-group randomized controlled trial** enrolled adults with suspected pulmonary or abdominal sepsis caused by an unknown pathogen. Both the intervention and control groups underwent the standard blood culture (BC) testing, but additional pathogen identification, based on the results of a LightCycler® SeptiFast PCR test, were provided in the intervention group.

RESULTS

The study enrolled 37 patients in the control group and 41 in the intervention group. Baseline clinical and demographic characteristics were similar in both groups. The PCR-based test identified a pathogen in 10 out of 41 (24.4%) patients in the intervention group, with a mean duration from sampling to providing the information to the ICU of 15.9 h. In the control group, BC results were available after a significantly longer period (38.1 h).

CONCLUSION

The LightCycler® SeptiFast PCR test demonstrated a significant reduction in the time required for initial pathogen identification, compared with standard BC.

摘要

目的

确定基于多重聚合酶链反应(PCR)的检测是否能缩短重症监护病房(ICU)患者初始病原体鉴定所需的时间。

方法

这项双盲、平行组随机对照试验纳入了由未知病原体引起的疑似肺部或腹部脓毒症的成年患者。干预组和对照组均接受标准血培养(BC)检测,但干预组根据LightCycler® SeptiFast PCR检测结果提供额外的病原体鉴定。

结果

该研究纳入了37名对照组患者和41名干预组患者。两组的基线临床和人口统计学特征相似。基于PCR的检测在干预组的41名患者中有10名(24.4%)鉴定出病原体,从采样到向ICU提供信息的平均时长为15.9小时。在对照组中,BC结果在显著更长的时间(38.1小时)后可得。

结论

与标准BC相比,LightCycler® SeptiFast PCR检测显示初始病原体鉴定所需时间显著缩短。

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