Towards precision medicine in sepsis: a position paper from the European Society of Clinical Microbiology and Infectious Diseases.

Details

Serval ID
serval:BIB_871E253C08EB
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Towards precision medicine in sepsis: a position paper from the European Society of Clinical Microbiology and Infectious Diseases.
Journal
Clinical microbiology and infection
Author(s)
Rello J., van Engelen TSR, Alp E., Calandra T., Cattoir V., Kern W.V., Netea M.G., Nseir S., Opal S.M., van de Veerdonk F.L., Wilcox M.H., Wiersinga W.J.
ISSN
1469-0691 (Electronic)
ISSN-L
1198-743X
Publication state
Published
Issued date
12/2018
Peer-reviewed
Oui
Volume
24
Number
12
Pages
1264-1272
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Our current understanding of the pathophysiology and management of sepsis is associated with a lack of progress in clinical trials, which partly reflects insufficient appreciation of the heterogeneity of this syndrome. Consequently, more patient-specific approaches to treatment should be explored.
To summarize the current evidence on precision medicine in sepsis, with an emphasis on translation from theory to clinical practice. A secondary objective is to develop a framework enclosing recommendations on management and priorities for further research.
A global search strategy was performed in the MEDLINE database through the PubMed search engine (last search December 2017). No restrictions of study design, time, or language were imposed.
The focus of this Position Paper is on the interplay between therapies, pathogens, and the host. Regarding the pathogen, microbiologic diagnostic approaches (such as blood cultures (BCs) and rapid diagnostic tests (RDTs)) are discussed, as well as targeted antibiotic treatment. Other topics include the disruption of host immune system and the use of biomarkers in sepsis management, patient stratification, and future clinical trial design. Lastly, personalized antibiotic treatment and stewardship are addressed (Fig. 1).
A road map provides recommendations and future perspectives. RDTs and identifying drug-response phenotypes are clear challenges. The next step will be the implementation of precision medicine to sepsis management, based on theranostic methodology. This highly individualized approach will be essential for the design of novel clinical trials and improvement of care pathways.
Keywords
Anti-Bacterial Agents/therapeutic use, Big Data, Biomarkers, Clinical Trials as Topic, Disease Management, Humans, Microbiota/drug effects, Poverty, Precision Medicine/methods, Sepsis/diagnosis, Sepsis/drug therapy, Sepsis/microbiology, Sepsis/physiopathology, Theranostic Nanomedicine/methods, Big data, Host defence, Low- and middle-income countries, Microbiome, Personalized medicine, Precision medicine, Rapid diagnostic test (RDT), Theranostics, Treatment
Pubmed
Web of science
Create date
29/03/2018 17:23
Last modification date
20/08/2019 14:46
Usage data