Sepsis is a heterogeneous disease state that is both common and consequential in critically ill patients. Unfortunately, the heterogeneity of sepsis at the individual patient level has hindered advances in the field beyond the current therapeutic standards, which consist of supportive care and antibiotics. This complexity has prompted attempts to develop a precision medicine approach, with research aimed towards stratifying patients into more homogeneous cohorts with shared biological features, potentially facilitating the identification of new therapies. Several investigators have successfully utilized leukocyte-derived mRNA and discovery-based approaches to subgroup patients on the basis of biological similarities defined by transcriptomic signatures. A critical next step is to develop a consensus sepsis subclassification system, which includes transcriptomic signatures as well as other biological and clinical data. This goal will require collaboration among various investigative groups, and validation in both existing data sets and prospective studies. Such studies are required to bring precision medicine to the bedside of critically ill patients with sepsis.

脓毒症是一种异质性疾病状态，在危重病患者中既常见又重要。不幸的是，脓毒症在个体患者水平上的异质性阻碍了该领域超越当前治疗标准（包括支持性护理和抗生素）的进展。这种复杂性促使人们尝试开发一种精准医学方法，研究旨在将患者分层为具有共同生物学特征的更同质的队列，从而有可能促进新疗法的识别。根据转录组特征定义的生物学相似性，一些研究人员已经成功地利用白细胞衍生的 mRNA 和基于发现的方法对亚组患者进行分析。关键的下一步是开发一个共识败血症子分类系统，其中包括转录组特征以及其他生物学和临床数据。这一目标将需要各个调查组之间的合作，并在现有数据集和前瞻性研究中进行验证。需要进行此类研究以将精准医疗带到患有败血症的危重患者的床边。