Importancia del diagnóstico de sepsis en el laboratorio clínico

Abstract

Septic disease is the immune imbalance in response to an infection capable of leading to multiorgan failure, worldwide there are an estimated 6 million deaths due to sepsis. Objective: To propose a comprehensive approach for the timely and accurate diagnosis of sepsis, through the determination and correlation between blood culture and procalcitonin. Methods: The present literature review considered a total of 35 articles selected through the PRISMA methodology. Results: Blood culture continues to be the gold standard for septic disease in identifying the microorganism, but its low specificity has led to the implementation of automated methods such as the BioFire® Blood Culture Identification Panel 2 (BCID2). Biomarkers include procalcitonin (PCT), C-reactive protein (CRP), lactate dehydrogenase (LDH), interleukin-6 (IL-6), ferritin and D-dimer (DD). Conclusions: The new automated methods have a shorter response time and both high levels of sensitivity and specificity. Similarly, it is important to measure PCT, CRP, IL-6 to guide the diagnosis, and to complement it with LDH associated with hypoperfusion, ferritin, severe sepsis and D-dimer with a picture of disseminated intravascular coagulation (DIC).