She Rosemary C, Bender Jeffrey M
Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA;
Division of Infectious Diseases of the Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, CA.
J Appl Lab Med. 2019 Jan;3(4):617-630. doi: 10.1373/jalm.2018.027409. Epub 2018 Nov 21.
For far too long, the diagnosis of bloodstream infections has relied on time-consuming blood cultures coupled with traditional organism identification and susceptibility testing. Technologies to define the culprit in bloodstream infections have gained sophistication in recent years, notably by application of molecular methods.
In this review, we summarize the tests available to clinical laboratories for molecular rapid identification and resistance marker detection in blood culture bottles that have flagged positive. We explore the cost-benefit ratio of such assays, covering aspects that include performance characteristics, effect on patient care, and relevance to antibiotic stewardship initiatives.
Rapid blood culture diagnostics represent an advance in the care of patients with bloodstream infections, particularly those infected with resistant organisms. These diagnostics are relatively easy to implement and appear to have a positive cost-benefit balance, particularly when fully incorporated into a hospital's antimicrobial stewardship program.
长期以来，血流感染的诊断依赖耗时的血培养以及传统的病原体鉴定和药敏试验。近年来，用于确定血流感染病原体的技术日益成熟，尤其是分子方法的应用。
在本综述中，我们总结了临床实验室可用于对已标记为阳性的血培养瓶进行分子快速鉴定和耐药标志物检测的试验。我们探讨了此类检测的成本效益比，涵盖性能特征、对患者护理的影响以及与抗生素管理计划的相关性等方面。
快速血培养诊断代表了血流感染患者护理方面的一项进步，尤其是对于感染耐药菌的患者。这些诊断方法相对易于实施，并且似乎具有积极的成本效益平衡，特别是当它们完全纳入医院的抗菌药物管理计划时。
