病原微生物分子检测技术在脓毒症诊断与预后评估中的临床价值

丁陈玲; 陈剑潇; 皋源

doi:10.13201/j.issn.1009-5918.2022.01.017

病原微生物分子检测技术在脓毒症诊断与预后评估中的临床价值

- 上海交通大学医学院附属仁济医院重症医学科(上海，200127)
基金项目:
上海市科学技术委员会科研计划项目(No：18411951100)

详细信息

通讯作者: 皋源, E-mail: gaoyuanzhuren@126.com

^△审校者

中图分类号: R459.7; R446.5

收稿日期: 2021-10-26

刊出日期: 2022-01-10

Molecular-based detection technologies of pathogens for sepsis

More Information

Corresponding author: GAO Yuan, E-mail: gaoyuanzhuren@126.com

Received Date: 26 October 2021

Publish Date: 10 January 2022

摘要

- 脓毒症 /
- 感染 /
- 微生物学技术 /
- 分子诊断技术
Abstract: Sepsis is one of the main causes of intensive care unit admission and the poor prognosis in critically ill patients. As sepsis progresses rapidly, antimicrobial therapy should be started as soon as possible. The present identification of pathogens, which is important for sepsis diagnosis and guiding antimicrobial therapy, is time-consuming and limited by poor detection performance, leading to the missing prompt and adequate antimicrobial therapy. Therefore, it is important to accelerate the identification of the causative species in patients with sepsis. Nowadays, many molecular-based detection techniques, characterized by fast detection and high sensitivity, have been applied in clinical practice, multiplex PCR and metagenomic sequencing, for example. In addition, some new molecular techniques, such as digital PCR, third generation sequencing and cell-free DNA sequencing are also being explored to make up for deficiencies of the current techniques, further accelerating the identification of pathogens, as well as improving the detection rate, which may provide new evidences for the early diagnosis, early identification of pathogens and prognostic assessment for patients with sepsis.
- sepsis /
- infection /
- microbiological techniques /
- molecular diagnostic techniques

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表 1 病原微生物分子检测技术

技术名称	方法	耗时/h	敏感度	特异度	最低检测限度/(CFU·mL^-1)
IridicaPlex ID^[12]	Multiplexed PCR+ESI-MS	6	77%~91%	87%~99%	0.25~128
SeptiFast^[13-14]	qRT-PCR+probe hybridization	6	60%~95%	74%~99%	3~100
SepsiTest^[14]	PCR+Sangersequencing	8~10	37.5%~78.6%	86.8%~94.4%	10~80
U-dHRM^[6]	dPCR+HRM	3			50~100
IC 3D^[17]	Droplet+DNA probe	1~4			10
Karius test^[25]	cfDNA sequencing	29	92.9%	62.7%
MinION^[26]	Nanopore sequencing	5~6

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参考文献(40)

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