The Dirac-von Neumann axioms define the general framework of QM, but to define a specific theory of matter in that framework, we need something more. Theories of non-interacting matter can (almost) be specified by choosing a symmetry group that includes translations in time. Choose the Galilei group and you end up with wave mechanics (i.e. wavefunctions, the Schrödinger equation and all that stuff). Choose the Poincaré group and you end up with relativistic quantum mechanics.
Two physical observers related by a Lorentz transformation g use different mathematical representations of the same state. (If you say "it's on my right", a rotated observer might say "it's in front of me"). If we want both of these guys to be able to predict probabilities of possible results of experiments, regardless of what g is, then we must assume that for each g in the group, there exists a symmetry T(g) on the set of unit rays. A symmetry is a bijection that preserves probabilities in the sense that if |\psi_1\rangle and |\psi_2\rangle belong to the rays R1 and R2 respectively, we have |\langle \psi_1|\psi_2\rangle|^2=|\langle \psi_1'|\psi_2'\rangle|^2 for all |\psi_1'\rangle and |\psi_2'\rangle belonging to the rays R2'=T(g)R1 and R2'=T(g)R2 respectively. A theorem proved by Wigner guarantees that for each g, there also exists an operator U(g) on the set of state vectors, that's either linear and unitary or antilinear and antiunitary. This is where it's significant that the group is a Lie group. I think the theorem assumes that we're dealing with a simply connected Lie group. That's why the proper orthochronous subgroup of the Lorentz group is so important.
The map U isn't quite a group homomorphism. Instead of U(gg')=U(g)U(g'), we have U(gg')=C(g,g')U(g)U(g'), where C(g,g') is a phase factor. There are some tricks we can use to get rid of the phase factor. The crucial step is to replace the rotation group SO(3) with its covering group SU(2). This doesn't change the physics significantly. So now we can deal with a unitary representation of a simply connected Lie group. Remarkably, these ideas lead directly to the concept of elementary particles. Each particle species corresponds to an irreducible representation. Check out chapter 2 in Weinberg for more details on this.
What remains to be specified in order to complete the theory is an identification of operators with observables. For example, when our g is a translation in time, the corresponding unitary operator can be expressed as exp(-iHt), and we identify this H with the observable "energy". These identifications can be partially justified, but I think we still have to consider them axioms.
What about quantum fields? We clearly don't need quantum fields to define particles, so what are they good for? They are used to specify interactions between particles. The non-interacting quantum field theories (theories derived from Lagrangians with no higher powers of the field components than the quadradic term) can also be used to explicitly construct irreducible representations and Hilbert spaces of one-particle states, which can then be used to construct the Fock space of state vectors of arbitrary numbers of non-interacting particles.