Abstract：
Polymicrobial sepsis is associated with worse patient outcomes than monomicrobial sepsis. Routinely used culture-dependent microbiological diagnostic techniques have low sensitivity, often leading to missed identification of all causative organisms. To overcome these limitations, culture-independent methods incorporating advanced molecular technologies have recently been explored. However, contamination, assay inhibition and interference from host DNA are issues that must be addressed before these methods can be relied on for routine clinical use. While the host component of the complex sepsis host-pathogen interplay is well described, less is known about the pathogen\'s role, including pathogen-pathogen interactions in polymicrobial sepsis. This review highlights the clinical significance of polymicrobial sepsis and addresses how promising alternative molecular microbiology methods can be improved to detect polymicrobial infections. It also discusses how the application of shotgun metagenomics can be used to uncover pathogen/pathogen interactions in polymicrobial sepsis cases and their potential role in the clinical course of this condition.
摘要：
多微生物败血症与比单一抗微生物败血症更差的患者预后相关。常规使用的培养依赖的微生物诊断技术灵敏度低，经常导致错过所有致病生物的鉴定。为了克服这些限制,最近已经探索了结合先进分子技术的非培养方法。然而,污染,来自宿主DNA的测定抑制和干扰是必须解决的问题,然后这些方法才能用于常规临床应用.虽然复杂的败血症宿主-病原体相互作用的宿主成分得到了很好的描述，对病原体的作用知之甚少，包括多微生物败血症中的病原体-病原体相互作用。这篇综述强调了多微生物败血症的临床意义，并探讨了如何改进有前途的替代分子微生物学方法来检测多微生物感染。它还讨论了如何使用鸟枪宏基因组学来揭示多微生物败血症病例中的病原体/病原体相互作用及其在这种情况的临床过程中的潜在作用。
