Personalized Medicine in Infectious Diseases

Severe acute infectious diseases, such as deep tissue infections and sepsis, are complex multifactorial diseases that can be caused by a variety of microbes. They are frequently complicated by septic shock and multi-organ failure. Despite modern medicine, the mortality is high, often exceeding 25%, and in the severe deep tissue infections, amputation is required in up to 15% of the cases. Patients affected may be young immunocompetent individuals or individuals with co-morbidities, e.g. cardiovascular diseases and diabetes mellitus. The fulminant, often rapid course of these invasive infections (in the order of hours), demands early diagnosis and prompt interventions. However, due to discrete and unspecific initial symptoms, scarce clinical findings and lack of specific biomarkers, there is a substantial risk for misdiagnosis and doctor’s delay. Thus, there is clearly an urgent need for improved diagnostics as well as and novel treatment options to improve outcome in these patients.

By virtue of the multifactorial nature of these infections, we strongly believe that individualized approaches are required to improve outcome of these patients. This concept is supported by the results obtained from the INFECT-project, in which a comprehensive systems medicine approach was used to understand the mechanisms underlying disease severity and outcome. our recent. The INFECT results, as well as clinical registry and biobank now offer a unique resource to the recently started multinational projects, PerAID and PERMIT, that aims to implement personalized medicine in severe infectious diseases. The two projects are ambitious covering both severe soft tissue infections and the large heterogeneous group of sepsis. Activities range from establishment of a Nordic platform for personalized medicine in infections, to translational research aimed to identify disease signatures and biomarkers that can be used for individualized therapy, to development of clinical decision support tools.