Abstract : Rapid diagnosis of sepsis is of outstanding significance as each hour of delay of appropriate antim
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Abstract : Rapid diagnosis of sepsis is of outstanding significance as each hour of delay of appropriate antimicrobial therapy increases mortality by 5-10. As a result antibiotics are started without a definitive microbial result based on clinical signs in concert with "biomarkers" with high sensitivity but a lack of specificity. Diagnostic uncertainty is compensated for by liberal use of broad spectrum antibiotics with inherent resistance as an increasing public-health problem. Blood culture reflects the current gold-standard but is positive only in approximately 20 of cases and even if positive results are obtained too late to influence decision making. Culture-independent microbial nucleic acid amplification techniques may allow ways out of this dilemma. In addition to diagnosis of infection "biomarkers" reflecting the host response can provide valuable information regarding prognosis course and response to treatment. Among available single protein markers procalcitonin (PCT) covers these features best and a PCT-based therapeutic strategy carries potential to reduce antibiotic courses even in life-threatening infections. Recent data from transcriptomic and/or proteomic profiling would however indicate that marker panels derived from transcriptomic or proteomic profiling are superior to single proteins to differentiate non-infectious from sepsis-associated systemic inflammation. Multiplexed assay systems e.g. after platform transfer from whole-genomic chips to multiplexed quantitative PCR are currently being developed with potential to improve sensitivity and specificity. Clinical utility of both molecular tests to identify the pathogen and the ensuing host response has still to be evaluated in prospective trials.Copyright 2010 Elsevier GmbH. All rights reserved.PMID 20510650 PubMed - indexed for MEDLINEPublication Types MeSH Terms SubstancesPublication Types ReviewMeSH TermsBiological Markers/analysis*Biological Markers/bloodGene Expression ProfilingHumansNucleic Acid Amplification Techniques/methods*Pathology MolecularProteomics/methodsSensitivity and SpecificitySepsis/diagnosis*SubstancesBiological MarkersLinkOut - more resourcesFull Text SourcesElsevier ScienceEBSCOOhioLINK Electronic Journal CenterSwets Information ServicesMedicalSepsis - MedlinePlus Health Information Supplemental Content Related citations Final Report on Carcinogens Background Document for Formaldehyde. Rep Carcinog Backgr Doc. 2010 Final Report on Carcinogens Background Document for Formaldehyde.National Toxicology Program. Rep Carcinog Backgr Doc. 2010 Jan (10-5981)i-512. Review Approaching clinical reality markers for monitoring systemic inflammation and sepsis. Curr Mol Med. 2010 Review Approaching clinical reality markers for monitoring systemic inflammation and sepsis.Claus RA Otto GP Deigner HP Bauer M. Curr Mol Med. 2010 Mar 10(2)227-35. Reliability of serum procalcitonin concentrations for the diagnosis of sepsis in neonates. Egypt J Immunol. 2008 Reliability of serum procalcitonin concentrations for the diagnosis of sepsis in neonates.Ali AM Moaz MA Ghoniem E Abd El Motaleb T Sheri N. Egypt J Immunol. 2008 15(1)75-84. Final Report on Carcinogens Background Document for Styrene. Rep Carcinog Backgr Doc. 2008 Final Report on Carcinogens Background Document for Styrene.National Toxicology Program. Rep Carcinog Backgr Doc. 2008 Sep (8-5978)i-398. Review Overview of resistance to systemic therapy in patients with breast cancer. Adv Exp Med Biol. 2007 Review Overview of resistance to systemic therapy in patients with breast cancer.Gonzalez-Angulo AM Morales-Vasquez F Hortobagyi GN. Adv Exp Med Biol. 2007 6081-22. See reviews... See all... Recent activity Clear Turn Off Turn On Molecular diagnostics of sepsis--where are we today? Molecular diagnostics of sepsis--where are we today?Int J Med Microbiol. 2010 Aug 300(6)411-3. Epub 2010 May 26 . PubMed Your browsing activity is empty. Activity recording is turned off. Turn recording back on See more... You are here NCBI gt Literature gt PubMed Write to the Help Desk Simple NCBI Directory Getting Started NCBI Education NCBI Help Manual NCBI Handbook Training amp Tutorials Resources Chemicals amp BioassaysData amp SoftwareDNA amp RNADomains amp StructuresGenes amp ExpressionGenetics amp MedicineGenomes amp MapsHomologyLiteratureProteinsSequence AnalysisTaxonomyTraining amp TutorialsVariation Popular PubMed Nucleotide BLAST PubMed Central Gene Bookshelf Protein OMIM Genome SNP Structure Featured GenBank Reference Sequences Map Viewer Genome Projects Human Genome Mouse Genome Influenza Virus Primer-BLAST Sequence Read Archive NCBI Information About NCBI Research at NCBI NCBI Newsletter NCBI FTP Site NCBI on Facebook NCBI on Twitter NCBI on YouTube NIH DHHS USA.gov Copyright | Disclaimer | Privacy | Accessibility | Contact National Center for Biotechnology Information U.S. National Library of Medicine 8600 Rockville Pike Bethesda MD 20894 USA
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