[Molecular biological detection of pathogens in patients with sepsis. Potentials, limitations and perspectives].

The wide variability of clinical symptoms and the ongoing difficulties concerning the rapid and specific laboratory diagnosis of sepsis, contribute to the fact that sepsis primarily remains a clinical diagnosis. To contribute to a more tailored antibiotic coverage of the patient early on in the course of the disease, modern diagnostic concepts favour the qualitative and quantitative molecular biological detection of blood stream pathogens directly from whole blood. This offers a very attractive alternative to the currently applied less sensitive and much more time-consuming blood culture-based laboratory methods. Moreover, recent study results suggest an increasing impact of molecular detection methods with short turn-around times for more effective treatment and better outcomes of patients with sepsis and septic shock. In the short term, such tests will not substitute conventional blood culture despite their superior rapidity and sensitivity, mainly because of higher cost. The amazing speed of ongoing scientific developments means, however, that techniques that might appear complicated, labour intensive, and costly today, will develop to become the future standards in the microbiological diagnosis of patients with sepsis and septic shock.