Lungu Olguta, Grigoras Ioana, Dorneanu Olivia Simona, Lunca Catalina, Vremera Teodora, Copacianu Stefania Brandusa, Ivanov Iuliu, Iancu Luminita Smaranda
Anaesthesia and Intensive Care Department, "Grigore T. Popa" University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania.
Anaesthesia and Intensive Care Department, Regional Institute of Oncology, 2-4 General Henri Mathias Berthelot Street, 700483 Iasi, Romania.
Pathogens. 2021 Mar 6;10(3):306. doi: 10.3390/pathogens10030306.
Health care-associated infections are a leading cause of inpatient complications. Rapid pathogen detection/identification is a major challenge in sepsis management that highly influences the successful outcome. The current standard of microorganism identification relies on bacterial growth in culture, which has several limitations. Gene sequencing research has developed culture-independent techniques for microorganism identification, with the aim to improve etiological diagnosis and, therefore, to change sepsis outcome. A prospective, observational, non-interventional, single-center study was designed that assesses biofilm-associated pathogens in a specific subpopulation of septic critically ill cancer patients. Indwelling device samples will be collected in septic patients at the moment of the removal of the arterial catheter, central venous catheter, endotracheal tube and urinary catheter. Concomitantly, clinical data regarding 4 sites (nasal, pharyngeal, rectal and skin) of pathogen colonization at the time of hospital/intensive care admission will be collected. The present study aims to offer new insights into biofilm-associated infections and to evaluate the infection caused by catheter-specific and patient-specific biofilm-associated pathogens in association with the extent of colonization. The analysis relies on the two following detection/identification techniques: standard microbiological method and next generation sequencing (NGS). Retrospectively, the study will estimate the clinical value of the NGS-based detection and its virtual potential in changing patient management and outcome, notably in the subjects with missing sepsis source or lack of response to anti-infective treatment.
医疗保健相关感染是住院患者并发症的主要原因。快速病原体检测/鉴定是脓毒症管理中的一项重大挑战，对成功治疗结果有很大影响。目前微生物鉴定的标准依赖于培养中的细菌生长，这存在一些局限性。基因测序研究已经开发出了不依赖培养的微生物鉴定技术，旨在改善病因诊断，从而改变脓毒症的治疗结果。设计了一项前瞻性、观察性、非干预性、单中心研究，以评估脓毒症重症癌症患者特定亚群中与生物膜相关的病原体。在脓毒症患者拔除动脉导管、中心静脉导管、气管内导管和导尿管时采集留置装置样本。同时，将收集患者入院/重症监护时病原体在4个部位（鼻腔、咽部、直肠和皮肤）定植的临床数据。本研究旨在为与生物膜相关的感染提供新的见解，并评估导管特异性和患者特异性生物膜相关病原体引起的感染与定植程度之间的关系。分析依赖于以下两种检测/鉴定技术：标准微生物学方法和下一代测序（NGS）。回顾性地，该研究将评估基于NGS检测的临床价值及其在改变患者管理和治疗结果方面的潜在作用，特别是在脓毒症来源不明或对抗感染治疗无反应的患者中。
