[Microbiological point of care tests].
It is well known that the early initiation of a specific antiinfective therapy is crucial to reduce the mortality in severe infection. Procedures culturing pathogens are the diagnostic gold standard in such diseases. However, these methods yield results earliest between 24 to 48 hours. Therefore, severe infections such as sepsis need to be treated with an empirical antimicrobial therapy, which is ineffective in an unknown fraction of these patients. Today's microbiological point of care tests are pathogen specific and therefore not appropriate for an infection with a variety of possible pathogens. Molecular nucleic acid diagnostics such as polymerase chain reaction (PCR) allow the identification of pathogens and resistances. These methods are used routinely to speed up the analysis of positive blood cultures. The newest PCR based system allows the identification of the 25 most frequent sepsis pathogens by PCR in parallel without previous culture in less than 6 hours. Thereby, these systems might shorten the time of possibly insufficient antiinfective therapy. However, these extensive tools are not suitable as point of care diagnostics. Miniaturization and automating of the nucleic acid based method is pending, as well as an increase of detectable pathogens and resistance genes by these methods. It is assumed that molecular PCR techniques will have an increasing impact on microbiological diagnostics in the future.
Universitätsklinik für Anästhesiologie und Schmerztherapie am Inselspital in Bern. Malte.Book@dkf.unibe.ch
Malte
M
Book
Lutz Eric
LE
Lehmann
Xianghong
X
Zhang
Frank
F
Stüber
D000890:Anti-Infective Agents / Q000627:therapeutic use; D004269:DNA, Bacterial / Q000235:genetics; D042241:Early Diagnosis; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D008828:Microbiological Techniques; D057089:Pathology, Molecular; D019095:Point-of-Care Systems; D012015:Reference Standards; D020133:Reverse Transcriptase Polymerase Chain Reaction
D000890:Anti-Infective Agents; D004269:DNA, Bacterial