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Chapter 22 : Future Trends in Diagnosis of Infections in the Immunocompromised Population

Authors: Elizabeth M. Marlowe1, Donna M. Wolk2
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Affiliations: 1: Southern California Permanente Medical Group, Regional Reference Laboratories, North Hollywood, CA 91605; 2: Department of Pathology, University of Arizona School of Medicine, Tucson, AZ 85724
Content Type: Monograph
Publication Year: 2009

Category: Clinical Microbiology

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Future Trends in Diagnosis of Infections in the Immunocompromised Population, Page 1 of 2

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Abstract:

The focused and unique health care management of the immunocompromised patient has grown significantly over the last several decades. Biomarkers of the immune response, such as procalcitonin (PCT), are evolving in clinical utility for the diagnosis of severe bacterial infections such as sepsis, for prediction of sepsis complications, and for therapeutic follow-up. Microbial and fungal infections are among the most common causes of high morbidity and mortality in critically ill patients in the United States; mortality rates can exceed 80%. Several molecular platforms are slated to play a role in advancing the diagnostic capabilities of clinical laboratories. Only time, cost-benefit studies, and practical evidence-based reviews can reveal the ultimate utility of these methods for diagnosis of infections in the immunocompromised population. Rapid testing for genetic resistance markers is an emerging clinical practice that can not only identify the potential for drug resistance but also help distinguish ambiguous breakpoints associated with susceptibility testing. Biomarkers of the immune response, such as PCT, are useful for the diagnosis of severe bacterial infections such as sepsis, for prediction of sepsis complications, and for therapeutic follow-up. Immunocompromised patients are a unique population, for which extreme measures may be required to make relevant diagnoses, prevent infection, or prevent overuse of health care resources.

Citation: Marlowe E, Wolk D. 2009. Future Trends in Diagnosis of Infections in the Immunocompromised Population, p 443-462. In Hayden R, Carroll K, Tang Y, Wolk D (ed), Diagnostic Microbiology of the Immunocompromised Host. ASM Press, Washington, DC. doi: 10.1128/9781555815455.ch22

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