病原性败血症病因和患者概况的特征:一种新的分类和治疗方法。

Microbiology insights Pub Date : 2019-01-27 eCollection Date: 2019-01-01 DOI:10.1177/1178636118825081
Hallie H Dolin, Thomas J Papadimos, Xiaohuan Chen, Zhixing K Pan
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引用次数: 51

摘要

致病性败血症不是一种单一的疾病。在这一类别中存在三种主要类型的败血症:细菌性、病毒性和真菌性,每种都有自己的作用机制。虽然症状相似,但这些类型的病因和免疫机制差异很大,因此可以为每种类型识别出离散的患者基础。不确定脓毒症起源的非特异性治疗,如广谱抗生素,可能会加重脓毒症症状,并导致患者发病率和死亡率增加。然而,对每一种败血症类型的可能患者的当前和历史模式的认识可能有助于在确定的血液检测之前区分病原体。临床医生可能最终能够诊断和治疗细菌性、病毒性和真菌性败血症,除了标准护理之外,还可以通过分析以前的患者模式和情况。这种方法可能会减少多药耐药菌的发生率,减少因治疗无效而导致的器官衰竭,减少每个败血症患者获得正确治疗的时间。最终,我们的目标是提供这些患者群体的分类信息,并建议基于流行病学的筛查方法,这些方法可以整合到重症监护医学中,特别是败血症的分诊和治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Characterization of Pathogenic Sepsis Etiologies and Patient Profiles: A Novel Approach to Triage and Treatment.

Characterization of Pathogenic Sepsis Etiologies and Patient Profiles: A Novel Approach to Triage and Treatment.

Pathogenic sepsis is not a monolithic condition. Three major types of sepsis exist within this category: bacterial, viral, and fungal, each with its own mechanism of action. While similar in symptoms, the etiologies and immune mechanisms of these types differ enough that a discrete patient base can be recognized for each one. Non-specific treatment, such as broad-spectrum antibiotics, without determination of sepsis origins may worsen sepsis symptoms and leads to increased morbidity and mortality in patients. However, recognition of current and historical patterns in likely patients for each sepsis type may aid in differentiation between pathogens prior to definitive blood testing. Clinicians may ultimately be able to diagnose and treat bacterial, viral, and fungal sepsis using analysis of previous patient patterns and circumstances in addition to standard care. This method is likely to decrease incidence of multidrug-resistant organisms, organ failure due to ineffective treatment, and turnaround time to the correct treatment for each sepsis patient. Ultimately, we aim to provide classification information on these patient populations and to suggest epidemiology-based screening methods that can be integrated into critical care medicine, specifically triage and treatment of sepsis.

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