[1]陈湘钰,潘小燕,李 静,等.生物标志物指导脓毒症患者抗生素使用的研究进展[J].医学信息,2023,36(13):182-187.[doi:10.3969/j.issn.1006-1959.2023.13.041]
 CHEN Xiang-yu,PAN Xiao-yan,LI Jing,et al.Research Progress of Biomarkers in Guiding the Use of Antibiotics in Patients with Sepsis[J].Journal of Medical Information,2023,36(13):182-187.[doi:10.3969/j.issn.1006-1959.2023.13.041]
点击复制

生物标志物指导脓毒症患者抗生素使用的研究进展()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年13期
页码:
182-187
栏目:
综述
出版日期:
2023-07-01

文章信息/Info

Title:
Research Progress of Biomarkers in Guiding the Use of Antibiotics in Patients with Sepsis
文章编号:
1006-1959(2023)13-0182-06
作者:
陈湘钰潘小燕李 静
(1.绵阳市中心医院肾内科,四川 绵阳 621000;2.成都医学院临床医学院,四川 成都 610500;3.四川绵阳404医院肾内科,四川 绵阳 621000)
Author(s):
CHEN Xiang-yuPAN Xiao-yanLI Jinget al.
(1.Department of Nephrology,Mianyang Central Hospital,Mianyang 621000,Sichuan,China;2.School of Clinical Medicine,Chengdu Medical College,Chengdu 610500,Sichuan,China;3.Department of Nephrology,Sichuan Mianyang 404 Hospital,Mianyang 621000,Sichuan,China
关键词:
脓毒症抗生素降钙素原C反应蛋白白细胞介素-6
Keywords:
SepsisAntibioticProcalcitoninC-reactive proteinIL-6
分类号:
R459.7
DOI:
10.3969/j.issn.1006-1959.2023.13.041
文献标志码:
A
摘要:
脓毒症是一种高死亡率的医疗紧急情况,快速启动抗菌治疗对脓毒症至关重要,由于缺乏准确的诊断方案及强有力的证据支撑安全地停止抗生素使用,抗菌药物持续时间通常超过疗程,不合理使用抗生素可导致药物不良事件、多重耐药菌产生等危害。因此,抗生素管理在脓毒症中非常重要。生物标志物对于优化抗生素管理的潜力已被广泛证实,本文主要针对常见生物标志物指导抗生素使用的国内外研究进行综述。
Abstract:
Sepsis is a medical emergency with high mortality and rapid initiation of antimicrobial therapy is critical for sepsis. Due to the lack of an accurate diagnosis plan and strong evidence to support the safe discontinuation of antibiotics, the duration of antibiotics usually exceeds the course of treatment, and irrational use of antibiotics can lead to adverse drug events and multidrug-resistant bacteria. Therefore, antibiotic stewardship is very important in sepsis patients. The potential of biomarkers to optimize antibiotic stewardship has been widely demonstrated, and this article reviews domestic and foreign studies on common biomarkers to guide antibiotic use.

参考文献/References:

[1]Evans L,Rhodes A,Alhazzani W,et al.Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021[J].Critical Care Medicine,2021,49(11):1063-1143.[2]Fleischmann-Struzek C,Mellhammar L,Rose N,et al.Incidence and mortality of hospital- and ICU-treated sepsis: results from an updated and expanded systematic review and meta-analysis [J].Intensive Care Medicine,2020,46(8):1552-1562.[3]Perner A,Gordon AC,De Backer D,et al.Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy[J].Intensive Care Med,2016,42(12):1958-1969.[4]Prescott H,Iwashyna T.Improving Sepsis Treatment by Embracing Diagnostic Uncertainty[J].Annals of the American Thoracic Society,2019,16(4):426-429.[5]Teshome B,Vouri S,Hampton N,et al.Duration of Exposure to Antipseudomonal β-Lactam Antibiotics in the Critically Ill and Development of New Resistance[J].Pharmacotherapy,2019,39(3):261-270.[6]Spellberg B,Bartlett J,Gilbert D.The future of antibiotics and resistance[J].The New England Journal of Medicine,2013,368(4):299-302.[7]Cole KA,Rivard KR,Dumkow LE.Antimicrobial Stewardship Interventions to Combat Antibiotic Resistance: an Update on Targeted Strategies[J].Curr Infect Dis Rep,2019,21(10):33.[8]Seymour C,Gesten F,Prescott H,et al.Time to Treatment and Mortality during Mandated Emergency Care for Sepsis[J].The New England Journal of Medicine,2017,376(23):2235-2244.[9]Opota O,Croxatto A,Prod’hom G,et al.Blood culture-based diagnosis of bacteraemia: state of the art[J].Clinical Microbiology and Infection,2015,21(4):313-322.[10]Grossmann S,Schroll S,Pfeifer M.Procalcitonin in the intensive care unit : Differential diagnostic and differential therapeutic possibilities[J].Med Klin Intensivmed Notfmed,2021,116(7):561-569.[11]Godinez-Vidal AR,Alcantara-Gordillo R,Aguirre-Rojano VI,et al.Evaluation of C-reactive protein, procalcitonin and the PCR/PCT index as indicators of mortality in abdominal sepsis[J].Cir Cir,2020,88(2):150-153.[12]Vujaklija Brajkovic A,Ko?觢uta I,Tomek D,et al.Utility of procalcitonin in a medical intensive care unit in Croatia[J].Wiener klinische Wochenschrift,2021,133:832-839.[13]Murri R,Mastrorosa I,Taccari F,et al.Procalcitonin is useful in driving the choice of early antibiotic treatment in patients with bloodstream infections[J].European Review for Medical and Pharmacological Sciences,2018,22(10):3130-3137.[14]Bassetti M,Russo A,Righi E,et al.Role of procalcitonin in predicting etiology in bacteremic patients: Report from a large single-center experience[J].Journal of Infection And Public Health,2020,13(1):40-45.[15]Wacker C,Prkno A,Brunkhorst F,et al.Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis[J].The Lancet Infectious Diseases,2013,13(5):426-435.[16]Jee Y,Carlson J,Rafai E,et al.Antimicrobial resistance: a threat to global health[J].The Lancet Infectious Diseases,2018,18(9):939-940.[17]Tujula B,Hamalainen S,Kokki H,et al.Review of clinical practice guidelines on the use of procalcitonin in infections[J].Infect Dis (Lond),2020,52(4):227-234.[18]Elnajdy D,El-Dahiyat F.Antibiotics duration guided by biomarkers in hospitalized adult patients; a systematic review and meta-analysis[J].Infectious diseases(London, England),2022,54(6):387-402.[19]Lee CC,Kwa ALH,Apisarnthanarak A,et al.Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: adaptation based on an expert consensus meeting[J].Clin Chem Lab Med,2020,58(12):1983-1991.[20]Ali WA,Bazan NS,Elberry AA,et al.A randomized trial to compare procalcitonin and C-reactive protein in assessing severity of sepsis and in guiding antibacterial therapy in Egyptian critically ill patients[J].Ir J Med Sci,2021,190(4):1487-1495.[21]De Jong E,Van Oers J,Beishuizen A,et al.Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients: a randomised, controlled, open-label trial[J].The Lancet Infectious Diseases,2016,16(7):819-827.[22]Peng F,Chang W,Xie J,et al.Ineffectiveness of procalcitonin-guided antibiotic therapy in severely critically ill patients: A meta-analysis[J].International journal of Infectious Diseases,2019,85:158-166.[23]Kyriazopoulou E,Liaskou-Antoniou L,Adamis G,et al.Procalcitonin to Reduce Long-Term Infection-associated Adverse Events in Sepsis. A Randomized Trial[J].American Journal of Respiratory and Critical Care Medicine,2021,203(2):202-210.[24]Dinarello CA.Targeting the pathogenic role of interleukin 1{beta} in the progression of smoldering/indolent myeloma to active disease[J].Mayo Clin Proc,2009,84(2):105-107.[25]Van Oers JAH,De Jong E,Kemperman H,et al.Diagnostic Accuracy of Procalcitonin and C-reactive Protein Is Insufficient to Predict Proven Infection: A Retrospective Cohort Study in Critically Ill Patients Fulfilling the Sepsis-3 Criteria[J].J Appl Lab Med,2020,5(1):62-72.[26]Weidhase L,Wellhofer D,Schulze G,et al.Is Interleukin-6 a better predictor of successful antibiotic therapy than procalcitonin and C-reactive protein? A single center study in critically ill adults[J].BMC Infect Dis,2019,19(1):150.[27]Liang P,Yu F.Value of CRP, PCT, and NLR in Prediction of Severity and Prognosis of Patients With Bloodstream Infections and Sepsis[J].Frontiers in Surgery,2022,9:857218.[28]Zincircioglu C,Rollas K,Guldogan I,et al.Diagnostic Value of Procalcitonin and C reactive Protein for Infection and Sepsis in Elderly Patients[J].Turk J Med Sci,2021,51(5):2649-2656.[29]Zhang Y,La M,Sun J,et al.Diagnostic Value and Prognostic Significance of Procalcitonin Combined with C-Reactive Protein in Patients with Bacterial Bloodstream Infection[J].Computational and Mathematical Methods in Medicine,2022,2022:6989229.[30]Perrella A,Giuliani A,De Palma M,et al.C-reactive protein but not procalcitonin may predict antibiotic response and outcome in infections following major abdominal surgery[J].Updates in Surgery,2022,74(2):765-771.[31]Thompson D,Huffman K,Kraus W,et al.Critical appraisal of four IL-6 immunoassays[J].PLoS One,2012,7(2):e30659.[32]Jawa R,Anillo S,Huntoon K,et al.Interleukin-6 in surgery, trauma, and critical care part Ⅱ: clinical implications[J].Journal of Intensive Care Medicine,2011,26(2):73-87.[33]Niu D,Huang Q,Yang F,et al.Serum biomarkers to differentiate Gram-negative, Gram-positive and fungal infection in febrile patients[J].Journal of Medical Microbiology,2021,70(7).[34]Rao L,Zhang K,Luo H,et al.The ability of inflammatory markers to recognize infection in cancer patients with fever at admission[J].Immunologic Research,2022,70(5):667-677.[35]Ma Y,Wang S,Yang M,et al.Analysis of Risk Factors and Clinical Indicators in Bloodstream Infections Among Patients with Hematological Malignancy[J].Cancer Management and Research,2020,12:13579-13588.[36]Mehra S,Tiwari A,Aggarwal G,et al.Diagnostic value of different interleukins and procalcitonin in critically ill patients admitted with suspected sepsis[J].Indian Journal of Pathology & Microbiology,2022,65(1):111-116.[37]董海燕,韩欣妍,孟丹丹,等.脓毒症治疗中利奈唑胺与万古霉素对降钙素原和C反应蛋白影响的差异[J].中国感染与化疗杂志,2020,20(4):406-412.[38]Urbonas V,Eidukaitè A,Tamulienè I.The predictive value of soluble biomarkers (CD14 subtype, interleukin-2 receptor, human leucocyte antigen-G) and procalcitonin in the detection of bacteremia and sepsis in pediatric oncology patients with chemotherapy-induced febrile neutropenia[J].Cytokine,2013,62(1):34-37.[39]Bamba Y,Moro H,Aoki N,et al.Increased presepsin levels are associated with the severity of fungal bloodstream infections[J].PLoS One,2018,13(10):e0206089.[40]Zhang J,Hu Z,Song J,et al.Diagnostic Value of Presepsin for Sepsis:A Systematic Review and Meta-Analysis[J].Medicine,2015,94(47):e2158.[41]Rhodes A,Evans L,Alhazzani W,et al.Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock:2016[J].Intensive Care Medicine,2017,43(3):304-377.[42]Masson S,Caironi P,Fanizza C,et al.Erratum to: Circulating presepsin (soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock: data from the multicenter, randomized ALBIOS trial[J].Intensive Care Medicine,2015,41(9):1736.[43]Venugopalan D,Pillai G,Krishnan S.Diagnostic Value and Prognostic Use of Presepsin Versus Procalcitonin in Sepsis[J].Cureus,2019,11(7):e5151.[44]Xiao H,Wang G,Wang Y,et al.Potential Value of Presepsin Guidance in Shortening Antibiotic Therapy in Septic Patients: a Multicenter, Prospective Cohort Trial[J].Shock (Augusta, Ga),2022,57(1):63-71.[45]Elke G,Bloos F,Wilson D,et al.The use of mid-regional proadrenomedullin to identify disease severity and treatment response to sepsis - a secondary analysis of a large randomised controlled trial[J].Critical care (London, England),2018,22(1):79.[46]Lorubbio M,Conti A,Ognibene A.Midregional pro-adrenomedullin (MR-ProADM) reference values in serum[J].Clinical Biochemistry,2018,53:173-174.[47]Li P,Wang C,Pang S.The diagnostic accuracy of mid-regional pro-adrenomedullin for sepsis: a systematic review and meta-analysis[J].Minerva Anestesiologica,2021,87(10):1117-1127.[48]Angeletti S,Dicuonzo G,Fioravanti M,et al.Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination[J].Disease Markers,2015,2015:951532.[49]Angeletti S,Battistoni F,Fioravanti M,et al.Procalcitonin and mid-regional pro-adrenomedullin test combination in sepsis diagnosis[J].Clinical Chemistry and Laboratory Medicine,2013,51(5):1059-1067.[50]Angeletti S,Spoto S,Fogolari M,et al.Diagnostic and prognostic role of procalcitonin (PCT) and MR-pro-Adrenomedullin (MR-proADM) in bacterial infections[J].APMIS,2015,123(9):740-748.[51]Valenzuela-Sánchez F,Valenzuela-Méndez B,Bohollo De Austria R,et al.Plasma levels of mid-regional pro-adrenomedullin in sepsis are associated with risk of death[J].Minerva Anestesiologica,2019,85(4):366-375.[52]Valenzuela-Sánchez F,Valenzuela-Méndez B,Rodríguez-Gutiérrez J,et al.New role of biomarkers: mid-regional pro-adrenomedullin, the biomarker of organ failure[J].Annals of Translational Medicine,2016,4(17):329.[53]Rasmussen L,Petersen J,Eugen-Olsen J.Soluble Urokinase Plasminogen Activator Receptor (suPAR) as a Biomarker of Systemic Chronic Inflammation[J].Frontiers in Immunology,2021,12:780641.[54]Backes Y,Van Der Sluijs K,Mackie D,et al.Usefulness of suPAR as a biological marker in patients with systemic inflammation or infection: a systematic review[J].Intensive Care Medicine,2012,38(9):1418-1428.[55]Huang Q,Xiong H,Yan P,et al.The Diagnostic and Prognostic Value of suPAR in Patients with Sepsis: A Systematic Review and Meta-Analysis[J].Shock (Augusta, Ga),2020,53(4):416-425.[56]Efat A,Shoeib S,Arafa A,et al.Thrombo-inflammatory biomarkers to predict sepsis outcome[J].International Journal of Immunopathology and Pharmacology,2021,35:20587384211048561.

相似文献/References:

[1]吴君华,吴友茹,李 丹.血清降钙素原在AECOPD抗感染治疗中的应用价值研究[J].医学信息,2018,31(02):74.[doi:10.3969/j.issn.1006-1959.2018.02.025]
 WU Jun-hua,WU You-ru,LI Dan.Study on the Application Value of Serum Calcitonin in the Anti Infection Treatment of AECOPD[J].Journal of Medical Information,2018,31(13):74.[doi:10.3969/j.issn.1006-1959.2018.02.025]
[2]温占兵.血管生成素-1水平变化预测脓毒症急性肺损伤的价值[J].医学信息,2018,31(13):95.[doi:10.3969/j.issn.1006-1959.2018.13.027]
 WEN Zhan-bing.The Value of Angiopoietin-1 Level Change in Predicting Acute Lung Injury in Sepsis[J].Journal of Medical Information,2018,31(13):95.[doi:10.3969/j.issn.1006-1959.2018.13.027]
[3]王晋蜀,黄梦雅,赵明丹,等.泌尿生殖道支原体感染检测、鉴定及耐药性分析[J].医学信息,2018,31(16):98.[doi:10.3969/j.issn.1006-1959.2018.16.029]
 WANG Jin-shu,HUANG Meng-ya,ZHAO Ming-dan,et al.Detection,Identification and Drug Resistance Analysis of Urogenital Mycoplasma Infection[J].Journal of Medical Information,2018,31(13):98.[doi:10.3969/j.issn.1006-1959.2018.16.029]
[4]于文清.下呼吸道感染病原菌分布及耐药性分析[J].医学信息,2018,31(24):74.[doi:10.3969/j.issn.1006-1959.2018.24.019]
 YU Wen-qing.Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Lower Respiratory Tract Infection[J].Journal of Medical Information,2018,31(13):74.[doi:10.3969/j.issn.1006-1959.2018.24.019]
[5]申 贵,彭 翔,秦光梅.抗感染督导治疗对脓毒症患者预后影响的研究[J].医学信息,2019,32(01):82.[doi:10.3969/j.issn.1006-1959.2019.01.026]
 SHEN Gui,PENG Xiang,QIN Guang-mei.Study on the Effect of Anti-infective Supervision on the Prognosis of Patients with Sepsis[J].Journal of Medical Information,2019,32(13):82.[doi:10.3969/j.issn.1006-1959.2019.01.026]
[6]张恺悦,陈幼琼.乌司他丁联合血必净对烧伤后脓毒症患者凝血功能及全身炎性反应的影响研究[J].医学信息,2019,32(04):138.[doi:10.3969/j.issn.1006-1959.2019.04.044]
 ZHANG Kai-yue,CHEN You-qiong.Effect of Ulinastatin Combined with Xuebijing on Coagulation Function and Systemic Inflammatory Response in Patients with Sepsis after Burn[J].Journal of Medical Information,2019,32(13):138.[doi:10.3969/j.issn.1006-1959.2019.04.044]
[7]张佳佳,李 庆,王 同.中性粒细胞CD64指数指导慢性阻塞性肺疾病急性加重期抗生素应用的探讨[J].医学信息,2019,32(07):78.[doi:10.3969/j.issn.1006-1959.2019.07.023]
 ZHANG Jia-jia,LI Qing,WANG Tong.The Application of Neutrophil CD64 Index in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J].Journal of Medical Information,2019,32(13):78.[doi:10.3969/j.issn.1006-1959.2019.07.023]
[8]杨勋能.参苓白术散对脓毒症患者肠道功能的影响[J].医学信息,2019,32(16):146.[doi:10.3969/j.issn.1006-1959.2019.16.049]
 YANG Xun-neng.Effect of Shenling Baizhu Powder on Intestinal Function in Patients with Sepsis[J].Journal of Medical Information,2019,32(13):146.[doi:10.3969/j.issn.1006-1959.2019.16.049]
[9]杜金洁,胡 鹏.ESKAPE病原菌感染引起脓毒症的研究[J].医学信息,2019,32(21):33.[doi:10.3969/j.issn.1006-1959.2019.21.012]
 DU Jin-jie,HU Peng.Study on Sepsis Caused by ESKAPE Pathogen Infection[J].Journal of Medical Information,2019,32(13):33.[doi:10.3969/j.issn.1006-1959.2019.21.012]
[10]宣恒报,成玉春,杨士军.医院感染的耐药菌分布特点与药物应用[J].医学信息,2019,32(22):114.[doi:10.3969/j.issn.1006-1959.2019.22.037]
 XUAN Heng-bao,CHENG Yu-chun,YANG Shi-jun.Distribution Characteristics and Drug Application of Drug-resistant Bacteria in Nosocomial Infection[J].Journal of Medical Information,2019,32(13):114.[doi:10.3969/j.issn.1006-1959.2019.22.037]

更新日期/Last Update: 1900-01-01