Review of Laboratory Methods in the Diagnosis of Sepsis
Raminta Jonikaitė, Silvija Kiverytė, Zita Aušrelė Kučinskienė
Summary
Sepsis is the most common cause of morbidtty and mortal ity in the hospi - talized critically ill patients worldwide. Rapid etiological diagnosis and the early administration of adequate antimicrobial therapy are important for successful outcome [1, 2].
Blood culture (BC) is considered to be the diagnostic gold standard of bloodstream infections, with high specificity in species identification, thought slow-growing and fastidious organisms can reduce the sensitivity. The diagnosis of sepsis with blood culture is a long process. There is a necessity to wait until the microorganisms multiply and reach a large number of cells. Usually, bacterial origin of the blood infection is confirmed within 48-72 h (a complete microbial identification and susceptibility profile). Fungal infections are confirmed normally for more than 72 h, and it may be because of blood negativity [3]. Due to the long lasttng microbiological test, the physician while identifying the infection has to rely solely on clinical symptoms and less “eloquent” laboratory tests such as white blood cell count, biochemical markers or fever.
Therefore, novel and faster laboratory methods for the diagnosis of sepsis have been developed [4, 5]. One of the potential rapid methods is the method of target-amplification based on pathogen nucleic acid polymerase chain reaction (PCR). This diagnostic method is much more sensitive and faster than blood culture. General methods that use genes for ribosomal RNA can create problems with contaminating bacteria, causing impaired analytical specificity and sensitivity.
Keywords: sepsis, blood infection, blood culture, mo lecu lar di ag no sis, polymerase chain reaction (PCR).
