RESUMEN
In response to inflammation there appear «reactants of acute phase¼ which are nonspecific but they can show the disease gravity and prognosis. The markers of the acute phase are: C-reactive protein (CRP), procalcitonin (PCT), neopterin (NP), presepsin (PSP), necrosis tumor factor α (NTF-α), erythrocyte sedimentation rate (ESR), the total amount of leucocytes, neutrophils, protein fractions (α, ß2, γ-globulins), IgM. CRP concentrations rise in the presence of bacterial infections and they are significanly higher in the positive blood cultures than in the contamination or negative ones. PCT levels grow in case of gram-negative bacteremia, but the levels are normal in case of coagulase-negative staphylococci bacteremia. PCT levels are more helpful here than CRP levels with suspected bacteremia. NP levels rise in patients with bacteremia. In the presence of infection, PSP becomes more active than CRP and PCT, and PSP sensitivity is 91,4% in patients with sepsis. Patients with infectious endocarditis have high levels of NTF-α in case of staphylococci infection in blood but the levels of NTF-α are low with enterococci and corynebacterium bloodstream infection. In case of inflammation the acute phase protein level changes are infection markers including bloodstream infection but they are not specific for determining any bacteremia aetiology.
Asunto(s)
Bacteriemia/diagnóstico , Biomarcadores/sangre , Inflamación/sangre , Proteína C-Reactiva/análisis , Humanos , Receptores de Lipopolisacáridos/sangre , Fragmentos de Péptidos/sangre , Polipéptido alfa Relacionado con Calcitonina/sangre , Factor de Necrosis Tumoral alfa/sangreRESUMEN
The sampling of270 out-patients was examined to detect principal clinical symptoms under infection of bloodstream. The principal clinical symptoms the form of complaints were collected using specially developed questionnaire. The patients mentioned most frequently low-grade fever, shivering, furuncles of skin, unstable stool (diarrhea or constipation), diseases of upper respiratory ways. The microbiological diagnostic of infection of bloodstream included microscopy and inoculation of leukocyte layer of blood sample. At microscopy of blood smears microorganisms were detected in 98.5% of cases. The positive findings were presented by associations of various morphological forms in 82.6% of cases. The hemoculture was obtained from 55.2% of patients and characterized by polymicrobility in 35.7% of cases. The greatest number of hemoculture were obtained from patients with low-grade fever and shivering (53.4%), furuncles (55.8%), unstable stool (53.6%), diseases of upper respiratory ways (53.8%) that substantiate presence of infection of bloodstream.