Biomarkers for Sepsis

Abstract

Bloodstream infections are a major concern because of high levels of antibiotic consumption and of the increasing prevalence of antimicrobial resistance. Bacteraemia is identified in a small percentage of patients with signs and symptoms of sepsis. Biomarkers are widely used in clinical practice and they are useful for monitoring the infectious process. Procalcitonin (PCT) and C-reactive protein (CRP) have been most widely used, but even these have limited abilities to distinguish sepsis from other inflammatory conditions or to predict outcome. PCT has been used to guide empirical antibacterial therapy in patients with respiratory infections and help to determine if antibacterial therapy can be stopped. New biomarkers such as those in this review will discuss the major types of biomarkers of bloodstream infections/sepsis, including soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), soluble urokinase-type plasminogen receptor (suPAR), proadrenomedullin (ProADM), and presepsin.

Role of hepcidin in the diagnosis of sepsis and septic shock in children

“…In addition, the comparison of WBC, CRP, PCT, IL-6, and hepcidin values in a diagnosis of sepsis and septic shock is very important. In distinguishing between sepsis and noninfective causes of inflammation in children and adults, the results of our study are consistent with the literature in that the specificity of PCT was higher than that of CRP, but they differ from the literature in that the sensitivity of CRP was higher than that of PCT (14)(15)(16)(17)(18). It was found in many child and adult studies that sepsis severity was associated with PCT and IL-6 but not associated with CRP (15,17,(19)(20)(21)(22)(23)(24).…”

“…Moreover, we were not able to examine WBC, CRP, and PCT levels due to inadequate blood volume collected from the healthy children. The levels of the biomarkers at the time the samples were taken may not reflect their actual levels because our data are cross-sectional, the half-lives of sepsis markers are different (14,(25)(26)(27), and the majority of patients had received antibiotic and fluid therapy prior to the PICU. Hepcidin is severely affected by anemia parameters such as serum and storage iron levels of patients regardless of the level of inflammation.…”

Bacterial sepsis

“…Due to its kinetics (response half-time, response-HT, up to 4-6 h), PCT is viewed as the diagnostic gold standard for bacterial infections [56,57]. In spite of these advantages, particularly locally limited infections, e. g., ventilator-associated pneumonia (VAP) or abscesses, can occurred without an increase in PCT [58,59].…”

“…The specificity of CRP for diagnosis of an infection is low [56]. Increases in CRP are not only observed during infection, but also after surgery, trauma, and burns, or in patients with acute (aseptic) pancreatitis.…”

Untitled

“…En adultos, el Receptor Desencadenante Soluble expresado en Células Mieloides-1 (sTREM-1), el plasminógeno soluble tipo Receptor de Uroquinasa(suPAR), la proadrenomedulina (pro-ADM) y la presepsina parecen prometedores debido a la aceptable sensibilidad y especificidad demostradas en los (11)(12)(13) diferentes estudios .…”