贾宜煊,仲盛年

脓毒症是一种严重的全身性炎症反应，可能会导致器官功能损伤，休克甚至多器官功能衰竭，严重时可危及患者的生命。治疗脓毒症的关键在于早期精准识别病原体，这对于降低患者死亡率具有至关重要的意义[1]。本文主要以确诊脓毒症患者感染的病原体方法进行阐述，结合其原理、优缺点和临床应用现状进行研究综述，为临床应用提供更可靠的参考依据。

脓毒症；微滴数字聚合酶链反应；血培养

[1] 黄伟.《第三版脓毒症与感染性休克定义国际共识》解读[J].中国实用内科杂志,2016,36(11):959-962. [2] 中国医师协会急诊医师分会,中国研究型医院学会休克与脓毒症专业委员会.中国脓毒症/脓毒性休克急诊治疗指南(2018)[J].临床急诊杂志,2018,19(09):567-588. [3] 曹钰,柴艳芬,邓颖,等.中国脓毒症/脓毒性休克急诊治疗指南(2018)[J].感染､炎症､修复,2019,20(01):3-22. [4] 刘婧,冯琳琳,张丽帆,等.血培养报阳时间在血流感染诊断及预后中的价值分析[J].中华医院感染学杂志,2021,31(11):1670-1674. [5] 马筱玲.如何正确解读血培养结果[J].中华检验医学杂志,2017,40(2):81-84. [6] Kumar A,Roberts D,Wood KE,et al.Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock[J].Critical Care Medicine,2006,34(6):1589-1596. [7] HINDSON B J,NESS K D,MASQUELIER D A,et al.High-throughput droplet digital PCR system for absolute quantitation of DNA copy number[J].Analytical Chemistry,2011,83(22):8604-8610. [8] T R H,Z G,J I,et al.Comparison of droplet digital PCR to real-time PCR for quantitative detection of cytomegalovirus.[J].Journal of clinical microbiology,2013,51(2):540-6. [9] LI H,BAI R,ZHAO Y,et al.Application of droplet digital PCR for detection of bacterial pathogens in bloodstream infections[J].Frontiers in Microbiology,2018,9:331. [10] SEDLAK R H,JEROME K R.Viral diagnostics in the era of digital PCR[J].Diagnostic Microbiology and Infectious Disease, 2013,75(1):1-4. [11] CUZON G,NAAS T,BOGAERTS P,et al.Evaluation of a DNA microarray for rapid detection of the most prevalent carbapenemase genes[J].Journal of Antimicrobial Chemotherapy,2011,66(6):1317-1321. [12] GU W,MILLER S,CHIU C Y.Clinical metagenomic next-generation sequencing for pathogen detection[J].Annual Review of Pathology:Mechanisms of Disease,2019,14:319-338. [13] BAKER M.Digital PCR hits its stride[J].Nature Methods,2012,9(6):541-544. [14] WHITE P L,BARNES R A,SPRINGER J,et al.Clinical performance of droplet digital PCR for the detection of Aspergillus DNA in serum[J].Journal of Clinical Microbiology,2015,53(8):2522-2528. [15] LI H,BAI R,ZHAO Y,et al.Application of droplet digital PCR for detection of bacterial pathogens in bloodstream infections[J]. Frontiers in Microbiology,2018,9:331. [16] Hall Sedlak R,Jerome KR.The potential advantages of digital PCR for clinical virology diagnostics.Expert Rev Mol Diagn.2014, 14(4):501-7.PMID:24724628. [17] Hindson CM,Chevillet JR,Briggs HA,et al.Absolute quantification by droplet digital PCR versus analog real-time PCR.Nat Methods. 2013,10(10):1003-5.PMID:23995387. [18] Zhu H,Zhang H,Xu Y,et al.PCR past,present and future.Biotechniques.2020,69(4):317-325.PMID:32815744. [19] Pallen MJ.Diagnostic metagenomics:potential applications to bacterial,viral and parasitic infections.Parasitology.2014,141(14):1856- 62.PMID:24576467. [20] Park C,Lee J,Hassan ZU,et al.Comparison of Digital PCR and Quantitative PCR with Various SARS-CoV-2 Primer-Probe Sets.J Microbiol Biotechnol.2021,28;31(3):358-367.PMID:33397829.

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