Diagnosing and Managing Sepsis by Probing the Host Response to Infection: Advances, Opportunities, and Challenges

Ian L Gunsolus, Timothy E Sweeney, Oliver Liesenfeld, Nathan A Ledeboer, Ian L Gunsolus, Timothy E Sweeney, Oliver Liesenfeld, Nathan A Ledeboer

Abstract

Sepsis is a major source of mortality and morbidity globally. Accurately diagnosing sepsis remains challenging due to the heterogeneous nature of the disease, and delays in diagnosis and intervention contribute to high mortality rates. Measuring the host response to infection enables more rapid diagnosis of sepsis than is possible through direct detection of the causative pathogen, and recent advances in host response diagnostics and prognostics hold promise for improving outcomes. The current review discusses recent advances in the technologies used to probe the host response to infection, particularly those based on transcriptomics. These are discussed in the context of contemporary approaches to diagnosing and prognosing sepsis, and recommendations are made for successful development and validation of host response technologies.

Keywords: bacteremia; host response; molecular diagnostics; sepsis; viremia.

Copyright © 2019 American Society for Microbiology.

Figures

FIG 1
FIG 1
The presence of infection and severity of illness can be envisioned along orthogonal diagnostic axes. Single-protein or -metabolite sepsis biomarkers face challenges distinguishing acute uncomplicated infections (upper left quadrant) from noninfectious critical illness (lower right quadrant) since available biomarker expression can be increased in both cases.

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