title: The era of molecular and other non-culture-based methods in diagnosis of sepsis.
abstract: Sepsis, a leading cause of morbidity and mortality throughout the world, is a clinical syndrome with signs and symptoms relating to an infectious event and the consequent important inflammatory response. From a clinical point of view, sepsis is a continuous process ranging from systemic inflammatory response syndrome (SIRS) to multiple-organ-dysfunction syndrome (MODS). Blood cultures are the current "gold standard" for diagnosis, and they are based on the detection of viable microorganisms present in blood. However, on some occasions, blood cultures have intrinsic limitations in terms of sensitivity and rapidity, and it is not expected that these drawbacks will be overcome by significant improvements in the near future. For these principal reasons, other approaches are therefore needed in association with blood culture to improve the overall diagnostic yield for septic patients. These considerations have represented the rationale for the development of highly sensitive and fast laboratory methods. This review addresses non-culture-based techniques for the diagnosis of sepsis, including molecular and other non-culture-based methods. In particular, the potential clinical role for the sensitive and rapid detection of bacterial and fungal DNA in the development of new diagnostic algorithms is discussed.
authors.affiliation: Laboratorio di Microbiologia e Virologia, Università Vita-Salute San Raffaele, Diagnostica e Ricerca San Raffaele, Milano, Italia. mancini.nicasio@hsr.it
authors.forename: Nicasio
authors.initials: N
authors.lastname: Mancini
authors.forename: Silvia
authors.initials: S
authors.lastname: Carletti
authors.forename: Nadia
authors.initials: N
authors.lastname: Ghidoli
authors.forename: Paola
authors.initials: P
authors.lastname: Cichero
authors.forename: Roberto
authors.initials: R
authors.lastname: Burioni
authors.forename: Massimo
authors.initials: M
authors.lastname: Clementi
mesh_terms: D001424:Bacterial Infections / Q000175:diagnosis*; D001769:Blood / Q000382:microbiology*; D019411:Clinical Laboratory Techniques / Q000379:methods*; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D009181:Mycoses / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology*; D013997:Time Factors