临床微生物学中的诊断管理:患者护理的不可或缺组成部分。

Diagnostic Stewardship in Clinical Microbiology: An Indispensable Component of Patient Care.

作者信息

Singhal Lipika, Gupta Parakriti, Gupta Varsha

机构信息

Department of Microbiology, Government Medical College and Hospital, Chandigarh-Sector 32, India.

出版信息

Infect Disord Drug Targets. 2025;25(2):e030724231543. doi: 10.2174/0118715265294425240607110713.

Abstract

Emerging infectious diseases and increasing resistance to available antimicrobials are mapping the evolution of clinical microbiology and escalating the nature of undertakings required. Rapid diagnosis has become the need of the hour, which can affect diagnostic algorithms and therapeutic decisions simultaneously. Subsequently, the concept of 'diagnostic stewardship' was introduced into clinical practice for coherent implementation of available diagnostic modalities to ensure that these new rapid diagnostic technologies are conserved, rather than consumed as part of health care resources, with a view to improve the patient care and reduce Turnaround Time (TAT) and treatment expense. The present study highlights the requisite of diagnostic stewardship and outlines the infectious disease diagnostic modalities that can assist in its successful implementation. Diagnostic stewardship promotes precise, timely diagnostics, from the initial specimen collection and identification to reporting with appropriate TAT, so as to enable timely management of the patient. The main aim of diagnostic stewardship is to optimize the right choice of diagnostic test for the right patient to attain clinically significant reports with the least possible TAT for timely management and the least expected adverse effects for the patient, community, and the healthcare system. This underlines the requisite of a multifaceted approach to make technological advancements effective and successful for implementation as a part of diagnostic stewardship for the best patient care.

摘要

新发传染病以及对现有抗菌药物耐药性的增加正在描绘临床微生物学的发展轨迹,并使所需工作的性质不断升级。快速诊断已成为当务之急,它能同时影响诊断算法和治疗决策。随后,“诊断管理”的概念被引入临床实践,以连贯实施现有的诊断方法,确保这些新的快速诊断技术得到保护,而不是作为医疗资源的一部分被消耗,目的是改善患者护理、缩短周转时间(TAT)并降低治疗费用。本研究强调了诊断管理的必要性,并概述了有助于其成功实施的传染病诊断方法。诊断管理促进从最初的标本采集、鉴定到以适当的周转时间进行报告的精确、及时诊断,从而实现对患者的及时管理。诊断管理的主要目标是为合适的患者优化诊断测试的正确选择,以获得具有临床意义的报告,同时尽可能缩短周转时间以便及时管理,并使患者、社区和医疗系统所面临的不良影响降至最低。这突出了采取多方面方法的必要性,以使技术进步作为诊断管理的一部分有效且成功地实施,从而实现最佳的患者护理。

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