血流感染病原微生物诊断技术的研究与应用

Research and application of diagnostic technology of pathogenic microorganisms in bloodstream infection

血流感染(BSI)是指病原微生物侵入血液循环并在体内繁殖的一种全身感染性疾病。近年来因其高发病率及病死率而受到越来越多的关注,如何实现BSI致病菌的快速检测及其药敏结果的准确回报,是长期困扰临床的问题。血培养是诊断BSI病原微生物的“金标准”,但其阳性率低且结果报告周期长,因此需探索新的技术以弥补此缺陷。近年来,微生物多种诊断技术,如阳性报警时间、核酸杂交技术、核酸扩增技术、质谱检测技术、基因芯片和测序技术等逐步从研究阶段走向BSI病原微生物诊断的临床应用阶段。本文旨在对BSI病原微生物基于全血标本和基于血培养的检测技术进行综述,为BSI病原微生物快速诊断和治疗提供方法学依据。

Bloodstream infection (BSI) is a systemic infectious disease in which pathogenic microorganisms invade in the blood circulation and reproduce in vivo.In recent years,more and more attention has been paid to BSI due to its high morbidity and mortality,and how to realize the rapid detection of pathogenic bacteria in BSI and the accurate return of their drug sensitivity results is a long-term clinical problem.Blood culture is the "gold standard" for the diagnosis of pathogenic microorganisms in BSI,but the positive rate is low and the reporting period is long.Therefore,new techniques need to be explored to remedy this defect.In recent years,many diagnostic techniques of microorganisms,such as positive alarm time,nucleic acid hybridization,nucleic acid amplification,mass spectrometry,gene chip and sequencing technology,have gradually moved from the research stage to the clinical application stage of BSI pathogenic microorganism diagnosis.The purpose of this paper is to review the detection techniques of BSI pathogenic microorganisms based on whole blood samples and blood culture,and to provide methodological basis for rapid diagnosis and treatment of BSI pathogenic microorganisms.