Gilbert David N
Infectious Diseases, Providence Portland Medical Center, Oregon Health and Sciences University, 5050 Northeast Hoyt, Suite 540, Portland, OR 97213, USA.
Infect Dis Clin North Am. 2017 Sep;31(3):435-453. doi: 10.1016/j.idc.2017.05.003.
The combination of molecular pathogen diagnostics and the biomarker procalcitonin (PCT) are changing the use of antimicrobials in patients admitted to critical care units with severe community-acquired pneumonia, possible septic shock, or other clinical syndromes. An elevated serum PCT level is good supportive evidence of a bacterial pneumonia, whereas a low serum PCT level virtually eliminates an etiologic role for bacteria even if the culture for a potential bacterial pathogen is positive. Serum PCT levels can be increased in any shocklike state; a low PCT level eliminates invasive bacterial infection as an etiology in more than 90% of patients.
分子病原体诊断与生物标志物降钙素原（PCT）的联合应用，正在改变重症监护病房中因严重社区获得性肺炎、可能的感染性休克或其他临床综合征而入院患者的抗菌药物使用情况。血清PCT水平升高是细菌性肺炎的有力支持证据，而血清PCT水平低实际上可排除细菌的病因作用，即使潜在细菌病原体的培养结果为阳性。在任何类似休克的状态下，血清PCT水平都可能升高；PCT水平低可排除超过90%患者的侵袭性细菌感染病因。
