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在严重疾病中区分感染,殖民和无菌炎症:宿主反应概况的新兴作用
Mark Jeffrey1,2, Kerina J Denny3,4, Jeffrey Lipman5,6,7
1John V Farman Intensive Care Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Intensive care medicine
|June 21, 2023
概括
在重症患者中区分真正的感染与殖民或无菌炎症是具有挑战性的. 除了检测病原体外,分析宿主免疫反应也是一种有前途的诊断方法.
科学领域:
- 关键护理医学 关键护理医学
- 传染病诊断 传染病诊断 传染病诊断
- 免疫学 免疫学 免疫学
背景情况:
- 危急病患者从无菌和传染性侮辱中表现出免疫激活,使感染诊断复杂化.
- 微生物群的转变和高度敏感的分子诊断进一步挑战了真正感染的识别.
- 从感染中区分殖民和无菌炎症对于有效的患者管理至关重要.
研究的目的:
- 审查当前的技术,以区分感染与殖民和无菌炎症.
- 探索新的宿主免疫反应分析方法,以提高诊断准确度.
- 为临床应用提出决策矩阵.
主要方法:
- 现有诊断方法的叙述性审查.
- 对宿主免疫反应标记物的分析 (转录组,蛋白质表达,免疫功能).
- 对新型分子诊断技术的评估.
主要成果:
- 目前用于区分殖民和感染的方法有限.
- 主体免疫反应概况显示了增强诊断歧视的潜力.
- 主体反应评估和病原体检测的组合可能是最优的.
结论:
- 在重症患者中,准确的感染诊断需要采用多方面的方法.
- 主体免疫反应概况为传统诊断提供了有价值的补充.
- 综合诊断策略将改善患者的治疗结果和抗微生物药物管理.
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