Gene polymorphisms in surgical patients with diffuse secondary periton it is-genetic predisposition for sepsis

Despite the great progress that has been made in recent decades in the intensive treatment of critically ill patients with intra abdominal infections, antibiotic therapy and modern surgical techniques, secondary peritonitis is still accompanied by significant morbidity and mortality. The response to infection can be variable between different individuals. Scientific evidence support hypothesis that this inter-patient variability can be at least partially explained by genetic influence which may have an important role in the development of sepsis, as well as in severity of complications and death. An infection triggers complex immune response of the host and affects the balance between coagulation and fibrinolysis. This imbalance can lead to hypercoagulability but also to the microcirculation disturbance which can lead to multiple organ dysfunction syndrome (MODS) and septic shock. Common polymorphisms of genes which encode proteins with important role in coagulation and fibrinolysis could be of great importance in susceptibility for sepsis, possible complications and clinical outcome. Early genetic information may become very useful for identification of patients with high risk of developing severe sepsis and multiple organ dysfunctions, in order to design better, more personalized therapy with less severe adverse effects.