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

Détails

ID Serval
serval:BIB_871E253C08EB
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Towards precision medicine in sepsis: a position paper from the European Society of Clinical Microbiology and Infectious Diseases.
Périodique
Clinical microbiology and infection
Auteur⸱e⸱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
Statut éditorial
Publié
Date de publication
12/2018
Peer-reviewed
Oui
Volume
24
Numéro
12
Pages
1264-1272
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
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.
Mots-clé
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
Création de la notice
29/03/2018 17:23
Dernière modification de la notice
20/08/2019 14:46
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