Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
LABBELS - Associate Laboratory, Braga/Guimarães, Portugal.
Pathog Dis. 2022 Sep 27;80(1). doi: 10.1093/femspd/ftac027.
Bloodstream infections (BSIs) and subsequent organ dysfunction (sepsis and septic shock) are conditions that rank among the top reasons for human mortality and have a great impact on healthcare systems. Their treatment mainly relies on the administration of broad-spectrum antimicrobials since the standard blood culture-based diagnostic methods remain time-consuming for the pathogen's identification. Consequently, the routine use of these antibiotics may lead to downstream antimicrobial resistance and failure in treatment outcomes. Recently, significant advances have been made in improving several methodologies for the identification of pathogens directly in whole blood especially regarding specificity and time to detection. Nevertheless, for the widespread implementation of these novel methods in healthcare facilities, further improvements are still needed concerning the sensitivity and cost-effectiveness to allow a faster and more appropriate antimicrobial therapy. This review is focused on the problem of BSIs and sepsis addressing several aspects like their origin, challenges, and causative agents. Also, it highlights current and emerging diagnostics technologies, discussing their strengths and weaknesses.
血流感染(BSI)和随后的器官功能障碍(败血症和感染性休克)是导致人类死亡的主要原因之一,对医疗保健系统有重大影响。它们的治疗主要依赖于广谱抗生素的使用,因为基于标准血培养的诊断方法对于病原体的鉴定仍然很耗时。因此,这些抗生素的常规使用可能导致下游的抗菌素耐药性和治疗结果失败。最近,在直接从全血中鉴定病原体的几种方法的改进方面取得了重大进展,特别是在特异性和检测时间方面。然而,为了在医疗机构中广泛应用这些新方法,仍需要进一步提高其敏感性和成本效益,以实现更快、更恰当的抗菌治疗。这篇综述集中讨论了血流感染和败血症的问题,涉及到它们的起源、挑战和病原体等方面。此外,还强调了当前和新兴的诊断技术,并讨论了它们的优缺点。