Managing sepsis in the era of precision medicine: challenges and opportunities

Abstract

Introduction: Precision medicine is a medical model in which decisions, practices, interventions and therapies are tailored to the individual patient based on their predicted response or risk of disease. Sepsis is a life-threatening condition characterized by immune system dysregulation whose pathophysiology remains incompletely understood. There is much hope that precision medicine can lead to better outcomes in patients with sepsis.

Areas covered: In this review from a comprehensive literature search in PubMed for English-language studies in adults, we highlight recent advances in the diagnosis and treatment of sepsis of bacterial origin using precision medicine approaches including rapid diagnostic tests, predictive biomarkers, genomic methods, rapid antimicrobial susceptibility testing, and monitoring cell mediated immunity. Challenges and directions for future research are also discussed.

Expert opinion: Current diagnostic testing in sepsis relies primarily on conventional cultures (e.g. blood cultures), which are time-consuming and may delay critical therapeutic decisions. Nonculture-based techniques including nucleic acid amplification technologies (NAAT), other molecular methods (biomarkers), and genomic sequencing offer promise to overcome some of the inherent limitations seen with culture-based techniques.

Keywords: antimicrobial susceptibility testing; biomarkers; blood stream infections; precision medicine; rapid diagnostic tests; sepsis.