Tjitske van Engelen

1. General introduction	9
Part I: Pathogenesis and host response	19
2. Pathogenesis of sepsis	21
3. Biomarkers in sepsis	37
4. Association of hyperferritinemia with distinct host response aberrations in patients with community-acquired pneumonia	61
5. Plasma protein biomarkers reflective of the host response in patients developing Intensive Care Unit-acquired pneumonia	83
Part II: Intermezzo – focus on the microbiome	129
6. Impact of Sepsis and Empiric Antimicrobial Therapy on the Gut Microbiome	131
7. Gut Microbiome Modulation by Antibiotics in Adult Asthma: A Human Proof-of-Concept Intervention Trial	151
Part III: Towards improvement of diagnosis and clinical care	165
8. Classifying the diagnosis of study participants in clinical trials: a structured and efficient approach	167
9. Ultra-low-dose CT versus chest X-ray for patients suspected of pulmonary disease at the emergency department: a multicentre randomised clinical trial	209
10. Limited clinical impact of Ultra-Low-Dose computed tomography in suspected community-acquired pneumonia	243
Part IV: Discussion and future perspective	255
11. Towards precision medicine in sepsis: a position paper from the European Society of Clinical Microbiology and Infectious Disease	257
12. General discussion	293
Part V: Summaries	303
13. Summary in English	305
14. Summary in Dutch - Nederlandse samenvatting	311
Addendum	317
Portfolio	318
List of contributors	322
Acknowledgements in Dutch – Dankwoord	331
About the author	333

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