naa a22 4500 551316454 CHVBK 20181213060116.0 cr unu---uuuuu 181213e201812 xx s 000 0 eng 10.1016/j.cmi.2018.03.011 doi (SERVAL)BIB_871E253C08EB 29581049 pmid 000451052700009 isiid Towards precision medicine in sepsis: a position paper from the European Society of Clinical Microbiology and Infectious Diseases [Elektronische Daten] [J. Rello, TSR van Engelen, E. Alp, T. Calandra, V. Cattoir, W.V. Kern, M.G. Netea, S. Nseir, S.M. Opal, F.L. van de Veerdonk, M.H. Wilcox, W.J. Wiersinga] 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. Rello J. aut van Engelen TSR aut Alp E. aut Calandra T. aut Cattoir V. aut Kern W.V. aut Netea M.G. aut Nseir S. aut Opal S.M. aut van de Veerdonk F.L. aut Wilcox M.H. aut Wiersinga W.J. aut Clinical microbiology and infection 24/12(2018-12), 1264-1272 24:12<1264-1272 2018 24 1 article serval SERVAL 700 1- Rello J. aut SERVAL 700 1- van Engelen TSR aut SERVAL 700 1- Alp E. aut SERVAL 700 1- Calandra T. aut SERVAL 700 1- Cattoir V. aut SERVAL 700 1- Kern W.V. aut SERVAL 700 1- Netea M.G. aut SERVAL 700 1- Nseir S. aut SERVAL 700 1- Opal S.M. aut SERVAL 700 1- van de Veerdonk F.L. aut SERVAL 700 1- Wilcox M.H. aut SERVAL 700 1- Wiersinga W.J. aut SERVAL 773 0- Clinical microbiology and infection 24/12(2018-12), 1264-1272 24:12<1264-1272 2018 24 BK010053 XK010053 XK010000 SERVAL SERVAL SERVAL article