金君 孙仁华 呼邦传

    [摘要] 血流感染是指病原微生物进入血液循环并生长繁殖，产生毒素、代谢产物，导致全身炎症反应的感染性疾病，是当前全世界临床医生面临的重大挑战之一。早期诊断并使用有效的抗感染方案能缩短抗生素使用时长、降低患者死亡率。血培养及药物敏感试验是目前临床诊断血流感染的金标准，但其存在病原学检测结果时间长、阳性率低等缺点，不能满足血流感染危重患者快速及精准治疗的需求。近年来随着分子检测技术的发展，涌现出DNA微阵列、质谱分析、数字PCR、二代高通量测序等分子诊断技术，较血培养能更快速地识别病原菌及耐药基因、提高检测的阳性率，指导临床医师早期进行目标抗生素干预，对改善血流感染患者临床预后具有潜在价值，并可降低病原菌耐药性。

    [关键词] 血流感染;血培养;分子诊断技术;研究进展

    [中图分类号] R631? ? ? ? ? [文献标识码] A? ? ? ? ? [文章编号] 1673-9701(2020)36-0182-06

    [Abstract] Bloodstream infection is an infectious disease in which pathogenic microorganisms enter the blood circulation， and grow and multiply， producing toxins and metabolites leading to systemic inflammation. It is one of the major challenges faced by clinicians all over the world. Early diagnosis and effective anti-infection regimens can shorten the duration of antibiotic use and reduce the mortality of patients. Blood culture and drug sensitivity test are the gold standards for clinical diagnosis of bloodstream infection， but they have disadvantages such as the time-consuming detection results of etiology and the low positive rate， which cannot meet the needs of rapid and precise treatment for critically ill patients with bloodstream infection. In recent years ......