20.500.12556/DKUM-47870 Pomen molekularne diagnostike za zdravljenje bolnikov s sepso in večorgansko odpovedjo ROLE OF MOLECULAR DIAGNOSTIC IN TREATMENT OF PATIENTS WITH SEPSIS AND MULTIORGAN FAILURES Sepsa je življenje ogrožujoče stanje, ki jo povzroči okužba in za katero je značilen sindrom sistemskega vnetnega odziva. Umrljivost za za septičnim šokom je 40-80%. Ob uvedbi antibiotičnega zdravljenja povzročitelja sepse večinoma ne poznamo in je začetna izbira antibiotika večinoma izkustvena. Ker je začetna izbira antibiotičnega zdravljenja izkustvena, približno 20% bolnikov s sepso ne prejme ustreznega antibiotika. Izbira ustreznega antibiotika je pomembna, saj ustrezno začetno antibiotično zdravljenje zmanjša umrljivost bolnikov s sepso. Osamitev povzročitelja s standardnimi hemokulturami navadno traja vsaj 24 ur.Novejše metode določanja povzročiteljev, ki temeljijo na verižni reakciji s polimerazo (iz ang. polymerase chain reaction), omogočajo hitrejšo zaznavo povzročitelja in posledično hitrejšo uvedbo ustreznega antibiotičnega zdravljenja. Vloga verižne reakcije s polimerazo pri zdravljenju bolnikov s sepso ni popolnoma pojasnjena. Sepsis is a life-threatening condition caused by infection and characterized by signs of systemic inflammatory response syndrome. The mortality rate is around 10-20% for sepsis, 20-50% for severe sepsis and 40-80% for septic shock. Since the initial choice of antibiotics is, in most cases, empirical, approximately 20% of patients with sepsis do not receive an appropriate antibiotic. Early appropriate antibiotic therapy is important because of reduction in mortality. To isolate pathogens by using standard blood cultures usually takes around 24 hours to the first, incomplete results, and about 3-5 days to complete test results including resistance to antibiotics. Newer methods of pathogen isolation, based on polymerase chain reaction, enable more rapid pathogen isolation and possibly faster institution of appropriate antibiotic therapy. In studies that have been performed so far using polymerase chain reaction assay in sepsis, different patient populations have been included, ranging from patients with fever to patients with septic shock and multi-organ failure, from patients who were treated in emergency departments and various hospital wards to intensive care units, studies included pediatric patients and adults. The role of polymerase chain reaction assay in the treatment of cohort of patients with severe sepsis and septic shock has not been defined. sepsa verižna reakcija s polimerazo hemokulture protimikrobna zdravila osamitev povzročitelja sepsis polymerase chain reaction blood cultures antimicrobial agents pathogen identification true false false Slovenski jezik Angleški jezik Doktorsko delo/naloga 2015-04-17 18:39:47 2016-12-19 13:51:09 2022-05-23 03:06:44 2021-05-08 03:19:11 2015 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 5846335 URN:SI:UM:DK:W8I9EHJ3 DOK_Markota_Andrej_2016.pdf DOK_Markota_Andrej_2016.pdf 1 E8E7A9F110DC86AFDCA99258A9CE89C6 4dffcaf188801ce9a3abac1a2a7610e2ffa37340bb552bd4f9924964eaa951ce dca958b8-7c0d-11eb-bb7a-00155d0001ca https://dk.um.si/Dokument.php?lang=slv&id=108323 Medicinska fakulteta 0 0 0