Alharbi Azzah S, Sanyi Raghad Hassan, Azhar Esam I
Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah 21362, Saudi Arabia.
Special Infectious Agent Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah 21362, Saudi Arabia.
World J Emerg Med. 2025;16(1):10-17. doi: 10.5847/wjem.j.1920-8642.2025.001.
Sepsis is a life-threatening inflammatory condition in which the invading pathogen avoids the host's defense mechanisms and continuously stimulates and damages host cells. Consequently, many immune responses initially triggered for protection become harmful because of the failure to restore homeostasis, resulting in ongoing hyperinflammation and immunosuppression.
A literature review was conducted to address bacterial sepsis, describe advances in understanding complex immunological reactions, critically assess diagnostic approaches, and emphasize the importance of studying bacterial bottlenecks in the detection and treatment of sepsis.
Diagnosing sepsis via a single laboratory test is not feasible; therefore, multiple key biomarkers are typically monitored, with a focus on trends rather than absolute values. The immediate interpretation of sepsis-associated clinical signs and symptoms, along with the use of specific and sensitive laboratory tests, is crucial for the survival of patients in the early stages. However, long-term mortality associated with sepsis is now recognized, and alongside the progression of this condition, there is an in vivo selection of adapted pathogens.
Bacterial sepsis remains a significant cause of mortality across all ages and societies. While substantial progress has been made in understanding the immunological mechanisms underlying the inflammatory response, there is growing recognition that the ongoing host-pathogen interactions, including the emergence of adapted virulent strains, shape both the acute and long-term outcomes in sepsis. This underscores the urgent need for novel high-throughput diagnostic methods and a shift toward more pre-emptive, rather than reactive, treatment strategies in sepsis care.
脓毒症是一种危及生命的炎症性病症，其中入侵的病原体逃避宿主的防御机制，并持续刺激和损害宿主细胞。因此，许多最初为保护而触发的免疫反应由于未能恢复体内平衡而变得有害，导致持续的炎症反应过度和免疫抑制。
进行了一项文献综述，以探讨细菌性脓毒症，描述在理解复杂免疫反应方面的进展，批判性地评估诊断方法，并强调研究细菌性脓毒症检测和治疗瓶颈的重要性。
通过单一实验室检测诊断脓毒症是不可行的；因此，通常会监测多个关键生物标志物，重点是趋势而非绝对值。对脓毒症相关临床体征和症状的即时解读，以及使用特异性和敏感性高的实验室检测，对患者早期生存至关重要。然而，现在已经认识到与脓毒症相关的长期死亡率，并且随着这种病症的进展，体内会出现适应性病原体的选择。
细菌性脓毒症仍然是所有年龄段和社会中死亡的重要原因。虽然在理解炎症反应背后的免疫机制方面已经取得了重大进展，但人们越来越认识到，持续的宿主-病原体相互作用，包括适应性强毒株的出现，塑造了脓毒症的急性和长期结局。这凸显了迫切需要新型高通量诊断方法，并在脓毒症护理中转向更具前瞻性而非反应性的治疗策略。
