SEPSIS IN THE GENOMIC ERA: GENETIC DETERMINANTS OF VIRULENCE AND ANTIMICROBIAL RESISTANCE

Abstract

Objectives. Sepsis is a major cause of morbidity and mortality worldwide, and its management is complicated by the diversity of etiological agents and virulence factors and by the spread of antimicrobial resistance. This review aimed to analyze and systematize recent evidence on the genetic determinants of virulence and antimicrobial resistance in the main etiological agents of sepsis.

Methods. This study is a narrative review of the literature published between 2020 and 2026. PubMed, Scopus, and Web of Science were searched using terms related to sepsis, genomics, virulence, and antimicrobial resistance. Of the 186 records identified, 14 full-text publications were included after duplicate removal and application of the eligibility criteria.

Results. The main etiological agents identified were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii. The reviewed literature highlights the role of genes involved in adhesion, biofilm formation, iron acquisition, toxin production, immune evasion, and systemic dissemination. Antimicrobial resistance is associated with acquired genes, chromosomal mutations, and mobile genetic elements. Whole-genome sequencing, metagenomics, and bioinformatics tools enable the rapid identification of pathogens, virulence genes, and resistance mechanisms and support the prediction of resistance profiles.

Conclusions. Genomics provides an important basis for precision microbiological diagnosis, epidemiological surveillance, and optimization of antimicrobial treatment in sepsis. Its clinical implementation nevertheless requires standardized bioinformatics workflows, rigorous quality control, and adequate infrastructure.