Szymański Mateusz, Skiba Małgorzata M, Piasecka Małgorzata
Human Anatomy Department, Medical University, Lublin, Poland.
Intensive Care Unit, Stefan Cardinal Wyszyński District Specialist Hospital, Lublin, Poland.
J Clin Lab Anal. 2025 Apr;39(8):e70021. doi: 10.1002/jcla.70021. Epub 2025 Mar 27.
Improving treatment outcomes sepsis requires early recognition, the implementation of appropriate treatment, and targeted antimicrobial therapy. Nowadays, microbiological diagnostic methods are available to accelerate microbiological diagnosis, thereby reducing the time needed to implement targeted antibiotic therapy. One method for rapid diagnosis is the amplified magnetic resonance imaging-T2 Biosystems, USA (T2Dx). This method enables the identification of pathogens directly from a blood sample (approximately 4 mL) within about 3.5 h. The use of the "T2 Resistance" panel additionally allows for the detection of the most common bacterial resistance mechanisms in about 4-5 h. The disadvantage of the T2Dx method is the limited number of microorganisms it can detect. The objective of the study was to evaluate the effectiveness of using selected inflammatory parameters to accurately qualify patients (positive result) for T2Dx testing.
We have made a retrospective evaluation of selected inflammatory parameters in order to determine which parameters are the best indicators for good qualification of patients.
A single analysis of parameters such as C-reactive protein (CRP), white blood cells (WBC), #neutr, #lymph, and neutrophil-to-lymphocyte ratio (NLR) is not a good indicator that could be used as an additional tool facilitating patient qualification for T2Dx testing. The most sensitive parameter distinguishing between patients with a positive T2Dx result and those with a negative result is the measurement of IL-6 and PCT. Proper patient qualification for T2Dx testing can significantly contribute to reducing the time to initiate targeted antibiotic therapy and may impact reducing mortality and improving long-term treatment outcomes.
改善脓毒症的治疗效果需要早期识别、实施恰当的治疗以及针对性的抗菌治疗。如今,有微生物诊断方法可加速微生物诊断,从而减少实施针对性抗生素治疗所需的时间。一种快速诊断方法是美国的磁共振成像 - T2生物系统公司(T2Dx)。该方法能够在约3.5小时内直接从一份血液样本(约4毫升)中鉴定病原体。使用“T2耐药性”检测板还能在约4 - 5小时内检测出最常见的细菌耐药机制。T2Dx方法的缺点是其能检测的微生物种类有限。本研究的目的是评估使用选定的炎症参数来准确判定患者是否适合进行T2Dx检测(阳性结果)的有效性。
我们对选定的炎症参数进行了回顾性评估,以确定哪些参数是判定患者是否适合检测的最佳指标。
对诸如C反应蛋白(CRP)、白细胞(WBC)、#中性粒细胞、#淋巴细胞以及中性粒细胞与淋巴细胞比值(NLR)等参数进行单一分析,并非是可作为辅助判定患者是否适合进行T2Dx检测的良好指标。区分T2Dx检测结果为阳性和阴性患者的最敏感参数是白细胞介素 - 6(IL - 6)和降钙素原(PCT)的测量值。对患者进行恰当的T2Dx检测判定,可显著有助于缩短开始针对性抗生素治疗的时间,并可能对降低死亡率和改善长期治疗效果产生影响。