血流感染的实验室诊断进展研究

Advances in laboratory diagnosis of bloodstream infections

血流感染(Bloodstream infection,BSI)是指病原微生物侵入血液循环并在体内繁殖。病原菌在血液循环中生长繁殖,产生毒素和其它代谢产物所引起的急性全身性感染称为脓毒败血症,也是引起死亡的主要原因。尽早发现感染的病原体并采取有效的抗菌药物治疗,对预防血流感染发展至脓毒血症及脓毒性休克,降低疾病的发病率和病死率有重要意义。目前,血培养仍然为血流感染诊断的参考方法,但其灵敏度低且耗时长。以聚合酶链式反应(PCR)为代表的分子生物学诊断技术可快速鉴定感染病原体同时筛查耐药基因。感染是病原体、宿主与环境相互作用的结果,利用多种组学技术可望为血流感染提供快速准确的实验室整合诊断。

Blood stream infections（BSI）are characterized by pathogens or conditional pathogens that invade the blood circulation and multiply in the body.Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated response to infection owing to toxin production as a result of BSI.Sepsis is an increasingly prevalent cause of death.Early identification of causal pathogens and antibiotic resistance initiates appropriate therapy in time to prevent the occurrence of severe septic shock.Blood culture remains the standard to establish the etiology of BSI,yet it is limited by long turnaround time（TAT）and low sensitivity.Molecular diagnostic technologies led by polymerase chain reaction（PCR）identify the causative pathogens and resistance genes in several hours.Infection can be viewed as a mosaic of complex interactions between pathogens,hosts and milieu.Holistic integrative approaches may provide rapid and accurate diagnosis of BSI by using advanced genomics technologies.