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Bakteriämie und Sepsis

Bacteremia and sepsis

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Zusammenfassung

Bakteriämie und Sepsis stellen im klinischen Alltag ein häufiges Problem dar. Von einer Bakteriämie spricht man bei kulturellem Nachweis von Bakterien im Blut. Es handelt sich um einen mikrobiologischen Befund, nicht um eine Diagnose. Die Sepsis dagegen ist eine klinische Diagnose, die weiter spezifiziert werden muss, wobei Kliniker, Epidemiologen und Mikrobiologen weiterhin unterschiedliche Definitionen und Terminologien verwenden. Diese Unterschiede zu kennen, ist für das Studium der Literatur und die Einordnung von Ergebnissen unabdingbar. Epidemiologische Studien belegen eine europaweite Zunahme der Bakteriämierate, sowohl im grampositiven als auch im gramnegativen Bereich. Die Ursache wird in der Zunahme der invasiven Diagnostik und Therapie bei gleichzeitig zunehmend multimorbiden und älter werdenden Patienten vermutet. Der vorliegende Beitrag liefert eine aktuelle Übersicht über wichtige diagnostische und therapeutische Aspekte der Sepsis und Bakteriämie.

Abstract

Bacteremia and sepsis are common problems in clinical practice. Bacteremia is the presence of bacteria in the blood, hence a microbiological finding. Sepsis is a clinical diagnosis needing further specification regarding focus of infection and etiologic pathogen, whereupon clinicians, epidemiologists and microbiologists apply different definitions and terminology. Knowing these differences is important when reading and interpreting the literature. Studies show a pan-European increase in the rate of bacteremia, both Gram-negative and Gram-positive. Reasons for this are an increase in invasive diagnostics and therapy, going along with increasing age of patients. Bacteremic infections are frequently healthcare related. This article illustrates recent aspects in diagnosis and therapy of sepsis and bacteremia.

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Danksagung

Das Universitätszentrum für Infektionsmedizin und Krankenhaushygiene des Universitätsklinikums Jena wird durch das Bundesministerium für Bildung und Forschung (BMBF; 01KI1204) gefördert.

Interessenkonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: S. Hagel: Vortragshonorare, Reisebeihilfen und/oder Forschungsbeihilfen von BMBF, MSD, Pfizer. M.W. Pletz: Vortragshonorare, Reisebeihilfen und/oder Forschungsbeihilfen von MSD, Pfizer, GSK, Bayer, Boehringer, Astellas, AstraZeneca, Gilead, ESCMID, BMBF, ARGUS-Stiftung, PEG, EU, DGIM. F.M. Brunkhorst: Vortragshonorare, Reisebeihilfen und/oder Forschungsbeihilfen von BMBF, BMG, Bayer, AstraZeneca, Thermo Fisher Scientific, Pfizer, Becton Dickinson, bioMérieux. H. Seifert: Vortragshonorare, Reisebeihilfen und/oder Forschungsbeihilfen von 3M, Astellas, AstraZeneca, Basilea, Baxter, Becton Dickinson, BMBF, Cubist, DGI, ESCMID, EU, Gilead, Infectopharm, MSD, Novartis, Oxoid, Pfizer, SIRS-Lab, Theravance. W.V. Kern: Vortragshonorare, Reisebeihilfen und/oder Forschungsbeihilfen von Astellas, AstraZeneca, Bayer, BMG, BMBF, Boehringer, Bundesärztekammer, DFG, DGI, ESCMID, EU, Gilead, GSK, Janssen, Kassenärztliche Bundesvereinigung, Landesgesundheitsamt Stuttgart, MSD, Pfizer, Siemens, Universität Bremen/Bertelsmann, RKI, Stiftung Warentest.

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Authors and Affiliations

  1. Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Erlanger Allee 101, 07740, Jena, Deutschland

    S. Hagel & M.W. Pletz

  2. Integriertes Forschungs- und Behandlungszentrum (IFB) Sepsis und Sepsisfolgen, Universitätsklinikum Jena, Jena, Deutschland

    S. Hagel, M.W. Pletz & F.M. Brunkhorst

  3. Paul-Martini-Forschergruppe für Klinische Sepsisforschung, Universitätsklinikum Jena, Jena, Deutschland

    F.M. Brunkhorst

  4. Institut für Medizinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Köln, Köln, Deutschland

    H. Seifert

  5. Zentrum Infektiologie und Reisemedizin, Universitätsklinikum Freiburg, Freiburg, Deutschland

    W.V. Kern

Authors
  1. S. Hagel
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  2. M.W. Pletz
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  3. F.M. Brunkhorst
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  4. H. Seifert
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  5. W.V. Kern
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Correspondence to S. Hagel.

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Hagel, S., Pletz, M., Brunkhorst, F. et al. Bakteriämie und Sepsis. Internist 54, 399–407 (2013). https://doi.org/10.1007/s00108-012-3185-4

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