[New methods for diagnosis of sepsis].
For the treatment of septic patients, it is important to perform a rapid and accurate identification of the causative microorganisms of the syndrome, and to use appropriate medicine. Blood culture has been an established method for the identification of causative bacteria in patients with sepsis, and the measurement of CRP has been used to estimate the severity of disorders. However, the blood culture method has a low sensitivity for detecting surviving bacteria in patients with sepsis because of the possible administration of antibiotics in advance of the test. Although the identification of causative bacteria must be performed quickly, the method requires several days to detect and identify the bacteria and to test for susceptibility to antibiotics. In addition, CRP measurement is not able to distinguish systemic bacterial infection from nonbacterial infection or non-infectious inflammation. To overcome the disadvantages of these tests for the diagnosis of sepsis, new methods have been developed. In this issue, we introduce two new methods for the diagnosis of sepsis. One involves the detection of the bacterial gene ingested by neutrophils by the in-situ hybridization method, and the other is the measurement of procalcitonin in blood samples. Since these tests have several advantages in comparison with the conventional blood culture method or the measurement of CRP to verify the presence of bacterial infection and identify the causal bacteria in a shorter period, we need to combine these tests with the conventional methods to facilitate an accurate diagnosis and administer appropriate antibiotics to septic patients.
Kaiga
Toshiyuki
T
Infection Control and Prevention Center, Gunma University Hospital, Maebashi 371-8511, Japan.
Ogiwara
Takayuki
T
Murakami
Masami
M
D001431:Bacteriological Techniques / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005798:Genes, Bacterial; D006801:Humans; D017403:In Situ Hybridization / Q000379:methods*; D009504:Neutrophils / Q000382:microbiology; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000175:diagnosis*
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide