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Präzisionsmedizin in der Infektiologie

Precision medicine in infectious diseases

  • Schwerpunkt: Präzisionsmedizin
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An Erratum to this article was published on 30 January 2024

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Zusammenfassung

Die Infektionsmedizin steht vor einer Vielzahl von Herausforderungen. Hierzu zählen die Zunahme von Antibiotikaresistenzen sowie die durch Klimawandel und Globalisierung begünstigte Entstehung und Ausbreitung infektiologischer Erkrankungen. Für viele dieser Herausforderungen kann die Präzisionsmedizin Lösungen bieten. Da eine ungezielte Anforderung diagnostischer Tests zu klinisch irrelevanten Testergebnissen führt, die den Einsatz von nicht indizierten Antibiotika erhöhen können, lautet das angestrebte Prinzip: gezielte Diagnostik („right test“) und Berücksichtigung der Patientencharakteristika („right person“) zur Optimierung des Managements („right action“). Gleichzeitig muss immer entschieden werden, ob eine sofortige empirische Therapie erforderlich ist, auch wenn die Ergebnisse der eingeleiteten Diagnostik noch nicht vorliegen. Zusätzlich wurden zuletzt viele neue Diagnostika zur raschen Erkennung sowie Therapien zur spezifischeren Behandlung von bakteriellen Infektionen entwickelt. Als neue Diagnostika setzen sich vor allem molekulargenetische Methoden durch, die raschere Ergebnisse bieten als klassische Bakterienkulturen. Neue Therapeutika wie Bakteriophagen, Antikörper oder antibakterielle Peptide erlauben eine immer präzisere Behandlung bestimmter bakterieller Infektionen. Die Präzisionsmedizin wird auch in der Infektionsmedizin einen immer größeren Stellenwert haben.

Abstract

Infectious medicine faces a variety of challenges, such as the increase in antibiotic resistance and the emergence and spread of infectious diseases fueled by climate change and globalization. Precision medicine can provide solutions to many of these challenges. Since an untargeted request for diagnostic tests can lead to test results without clinical relevance, which can increase the use of non-indicated antibiotics, the principle aimed at is: targeted diagnostics (the right test) and consideration of patient characteristics (the right person) to optimize management (the right action). At the same time, one must always decide whether empirical therapy must be immediately initiated, even if the results of the initiated diagnostics are not yet available. In addition, many new diagnostics as well as therapies have recently been developed for the rapid detection and more specific treatment of bacterial infections. Molecular genetic methods, which offer more rapid results than classical bacterial cultures, are gaining ground as new diagnostics. New therapeutics such as bacteriophages, antibodies or antibacterial peptides allow increasingly precise treatment of certain bacterial infections. Precision medicine will also play an increasingly important role in infectious medicine in the future.

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  1. Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Klinik I für Innere Medizin, Infektiologie, Köln, Deutschland

    N. Jung Dipl.-Chem.,  P. Schommers & C. Leisse

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  1. N. Jung Dipl.-Chem.
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  2. P. Schommers
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  3. C. Leisse
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Correspondence to N. Jung Dipl.-Chem..

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Interessenkonflikt

N. Jung erhielt Vortragshonorare von AbbVie, Bayer, Infectopharm und Medacta, Reisekostenzuschüsse von Gilead und Pfizer und Beraterhonorare von MSD.

P. Schommers erhielt Vortags- und Beraterhonorare von Gilead und VIIV, Drittmittelunterstützung von Gilead und hat Patente zu antiinfektiven Antikörpern angemeldet.

C. Leisse gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Die Originalversion wurde korrigiert: Die Adressdaten bzw. die Daten zur institutionellen Zugehörigkeit der Autoren waren falsch angegeben.

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Jung, N., Schommers, P. & Leisse, C. Präzisionsmedizin in der Infektiologie. Innere Medizin 65, 220–227 (2024). https://doi.org/10.1007/s00108-023-01620-z

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