Question

In sepsis, should the infection organism be sequenced first if both are known?

1) Yes, the infection organism should be sequenced first
2) No, the infection organism should not be sequenced first
3) It depends on the specific case
4) Cannot be determined

Answer 1

Quickly identifying the causative agent in sepsis and starting antibiotic therapy is clinically prioritized over full organism sequencing. Sequencing might be conducted in specific cases but is not usually the immediate focus in sepsis management.

Step-by-step explanation:

In the context of sepsis, the sequencing of the infecting organism is not always prioritized over immediate treatment. The typical clinical priority is to quickly identify the causative agent through blood cultures and imaging studies and to begin appropriate antibiotic therapy as soon as possible to manage the infection and prevent the progression to severe sepsis or septic shock. Complete organism sequencing might be utilized in specific cases, such as when infections are resistant to initial treatments or in epidemiological studies, but it is not typically the first step in the management of sepsis.

The guidance provided by Koch's postulates, particularly with the need to isolate and grow the suspected pathogen in pure culture, aligns with identifying the pathogen responsible for a disease. However, in the emergency treatment of sepsis, there is not always time to wait for complete sequencing before starting treatment. Furthermore, modern variations of Koch's postulates accommodate molecular methods, but these also do not supersede the immediate clinical needs of a septic patient.