[Infectious diseases--new horizons].

During the last decade we have witnessed important developments in the field of infectious diseases. These developments have in a large part been made possible due to our entry into the genomic period. The main areas of progress include diagnosis, understanding of the pathophysiology, genetics, anti-microbial therapy and the prevention of disease by new vaccines. The diagnosis of infection using Polymerase Chain Reaction (PCR), contributes today to the early identification of a pathogen, long before the culture and serology. In the future, we will be able to utilize molecular methodologies based on the unique response of the host to a specific infection--the genetic signature. This method will enable very early identification of the pathogen, institution of optimal treatment, and will prevent the excessive use of antibiotics. Another area that has developed in recent years is the genetics of infectious diseases. Accumulated data shows that changes in the genome, polymorphism, result in different reactions by people to different infections. As a result of these changes some people are resistant to certain infections whilst others are especially sensitive to other infections. Introduction of this knowledge into clinical practice will enable more rational medical management with an emphasis on personalized medicine. After a long period without the development of new antibiotics, there are now signs of conceptual and practical breakthroughs in the development of antibiotic agents whose activity is based on new principles and directed against sites different from those of existing antibiotics. These advances are predominantly due to progress in the field of genomics. Similarly, in the development of future vaccines, more and more vaccines will be developed using genomic methods, enabling the creation of vaccines against diseases that we have not yet succeeded to eradicate. Genomic methods will enable the design of vaccines tailored to the specific genomic structure of the host--personal vaccines. All these four aspects of progress in the field of infectious diseases are not science fiction, and it can be stated with confidence that the future is already here.