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[Debatable questions of surgical sepsis treatment and diagnosis]
Abstract:
On the basis of critical analysis of the results of combined treatment of 73 patients, the authors suggested that sepsis could be diagnosed only in the presence of systemic inflammatory response, multiorganic insufficiency and obligatory isolation of hemoculture. The microorganisms' specimen from the infected area and the blood are not identical both in primary and repeated inoculation. Impossibility to verify the pathogenic microorganism in the blood prevents from carrying out adequate and purposeful treatment. The absence of correlation between the severity of clinical course of sepsis, microflora species and laboratory immunography data, confirms the opinion that the organism responds to the inflammatory process by complex general physiologic reaction of defence, which includes, besides immunologic system, fermentative, endocrine, vegetative and other systems of homeostasis.
Insights
Sepsis diagnosis requires systemic inflammatory response, organ insufficiency, and positive blood cultures. Discrepancies in microbial identification between infection sites and blood hinder effective sepsis treatment.
Area of Science:
- Critical care medicine
- Infectious diseases
- Microbiology
Context:
- Sepsis diagnosis and treatment remain challenging clinical issues.
- Accurate identification of causative pathogens is crucial for effective therapy.
- Understanding the host's systemic response is key to managing sepsis.
Purpose:
- To critically analyze the diagnostic criteria for sepsis.
- To investigate the correlation between microbial findings and clinical presentation.
- To evaluate the host's physiological response in sepsis.
Summary:
- Sepsis diagnosis necessitates systemic inflammatory response, multiorganic insufficiency, and confirmed hemoculture isolation.
- Microbial specimens from infection sites and blood often differ, complicating treatment.
- Lack of correlation between clinical severity, microflora, and immunography suggests a complex host defense mechanism.
Impact:
- Highlights the need for precise diagnostic markers in sepsis.
- Emphasizes the importance of blood culture accuracy for targeted antimicrobial therapy.
- Suggests that sepsis involves a multifaceted physiological defense beyond the immune system.