Sepsis in the ICU : improving pathogen detection and understanding of infectious complications

Timely recognition, initiation of appropriate antimicrobial therapy, and prompt control over the anatomic source of the infection are pivotal for improving patient outcome in sepsis. The first part of this thesis describes the diagnostic performance of blood cultures and a new molecular assay for pathogen detection in ICU patients with sepsis. This new test detects bacterial DNA directly in blood and could shorten the time to diagnosis. In the second part of this thesis, three infectious complications observed in sepsis patients were studied, aiming to facilitate timely recognition and subsequent treatment. The studies in this these were performed within the cohort of the Molecular Diagnosis and Risk Stratification of Sepsis (MARS) study, which consists of both a detailed database and a fully integrated biobank.