Rapid diagnosis of sepsis

Bloos, Frank; Reinhart, Konrad

doi:10.4161/viru.27393

Cited by 137 publications

(128 citation statements)

References 98 publications

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“…Compared to CRP or PCT, IL-6 levels peak 2 h after initiation of the inflammatory cascade. Based on this rapid increase, IL-6 was introduced as a biomarker of early sepsis in emergency units [38,39] . A multicenter study showed that IL-6 can predict survival on the 28 th day after sepsis onset [40] .…”

Section: Il-6mentioning

confidence: 99%

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Kojic

Siegler

Uhle

et al. 2015

WJEM

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Beside many efforts to improve outcome, sepsis is still one of the most frequent causes of death in critically ill patients. It is the most common condition with high mortality in intensive care units. The complexity of the septic syndrome comprises immunological aspects -i.e. , sepsis induced immunosuppression -but is not restricted to this fact in modern concepts. So far, exact mechanisms and variables determining outcome and mortality stay unclear. Since there is no typical risk profile, early diagnosis and risk stratification remain difficult, which hinders rapid and effective treatment initiation. Due to the heterogeneous nature of sepsis, potential therapy options should be adapted to the individual. Biomarkers like C-reactive protein and procalcitonin are routinely used as complementary tools in clinical decision-making. Beyond the acute phase proteins, a wide bunch of promising substances and non-laboratory tools with potential diagnostic and prognostic value is under intensive investigation. So far, clinical decision just based on biomarker assessment is not yet feasible. However, biomarkers should be considered as a complementary approach. Core tip: Sepsis is a complex continuum of disturbed systems. Despite the presence of clinical consensus criteria, the early diagnosis especially in the perioperative setting is challenging. A magnitude of potential new biomarkers is tested for this purpose, but evidence is mounting that due to the complex nature of the syndrome, biomarkers are rather complementary tools for clinical decision making than "magic bullets". Moreover, biomarkers are also evaluated for therapy guidance, linking diagnostic results to an individual therapeutic regime. This review summarizes the developments in the biomarker field, aiming to provide an overview about current targets and their limitations.

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Section: Il-6mentioning

confidence: 99%

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Kojic

Siegler

Uhle

et al. 2015

WJEM

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“…However, biomarkers can aid and shorten this decision process when taking into account the shortcomings of biomarkers. Procalcitonin is currently the most investigated biomarker for this purpose and the only biomarker which has been integrated into treatment algorithms 14 . Recently, the biomarkers used as diagnostic criteria for sepsis, plasma CRP or PCT levels more than 2 standard deviations (SD) above the normal value, are now part of the inflammatory variables which, together with infection, whether documented or suspected, constitute a definition of sepsis 6,15 .…”

Section: Resultsmentioning

confidence: 99%

Comparison of Procalcitonin and C-reactive Protein in Differential Diagnosis of Sepsis and Severe Sepsis in Emergency Department

Erenler¹,

Yapar²,

Terzi³

2017

Dicle Tıp Dergisi

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Objective: Sepsis and severe sepsis (sepsis accompanied by acute organ dysfunction) are leading causes of death worldwide. In this study, our aim was to investigate utility of biomarkers commonly used in diagnosis of sepsis in discriminating these two entities. Methods: Two-hundred and three patients involved were divided into 2 subgroups as sepsis and severe sepsis according to Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012. Then groups were compared according to clinical and laboratory (including C-reactive protein (CRP) and procalcitonin (PCT) levels) characteristics. Results: Of 203 patients included into the study, 124 (61.1%) were male and 79 (38.9%) were female. The most common reason for sepsis was urinary tract infection (n=64, 31.5%), followed by catheter infection (n=16, 7.9%) and pneumonia (n=14, 6.9%). Escherichia coli was the most common agent in both blood and urinary cultures. Majority of the patients were treated with ceftriaxone (n=33, 16.3%), followed by meronem/dapson (n=25, 12.3%). In both groups, CRP and PCT levels were high, even higher in severe sepsis group. However, any statistical significance could not be determined between groups. Mortality rate in sepsis patients was 6.4%. Conclusion: Plasma levels of both markers elevate in sepsis and severe sepsis. It was determined that CRP and PCT is higher in severe sepsis than in sepsis. However, the difference is not statistically significant. Plasma levels of CRP and PCT are not useful in differential diagnosis of sepsis and severe sepsis. Keywords: C-reactive protein, procalcitonin, sepsis, severe sepsis, Emergency department 176 Acil Serviste Sepsis ve Şiddetli Sepsisin Ayırıcı Tanısında Prokalsitonin ve C-reaktif Proteinin KarşılaştırılmasıÖzet Amaç: Sepsis ve şiddetli sepsis (akut organ disfonksiyonunun eşlik ettiği sepsis) dünyada ölümlerin başlıca nedenlerindendir. Bu çalışmada amacımız, sepsis tanısında sıkça kullanılan biyobelirteçlerin bu iki durumun ayrımındaki yararlılıklarını araştırmaktır. Yöntemler: Dahil edilen 203 hasta; Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012 kılavuzuna göre sepsis ve şiddetli sepsis olmak üzere iki gruba ayrılmıştır. Daha sonra gruplar klinik ve laboratuar (C-reaktif protein (CRP) ve prokalsitonin (PCT) dahil olmak üzere) özelliklerine göre karşılaştırılmıştır. Bulgular: Çalışmaya katılan 203 hastanın 124 (%61,1)'ü erkek, 79 (%38,9)'u kadındı. Sepsisin en sık nedeni üriner sistem enfeksiyonlarını (n=64, %31,5) takiben kateter enfeksiyonları (n=16, %7,9) ve pnömoni (n=14, %6,9) idi. Üriner ve kan kültürlerinde en sık ajan Escherichia coli olarak tespit edildi. Hastaların çoğu seftriakson (n=33, %16,3) ile tedavi edilirken bunu meronem/dapson (n=25, %12,3) tedavisi takip etti. Her iki grupta da CRP ve PCT düzeyleri yüksek iken şiddetli sepsis grubunda daha yüksek saptandı. Ne var ki, gruplar arasında istatistiksel olarak anlamlı fark tespit edilemedi. Sepsis hastalarında mort...

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“…Studies conducted on the differential diagnosis of sepsis and NI-SIRS in recent years have focused on the indicators which yield results more rapidly in the early period. Among them, clinical scoring systems such as the SOFA and immunological markers such as procalcitonin and sTREM-1 are the leading ones (3,7,13).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, laboratory investigations yielding rapid and accurate results to support the diagnosis are needed. Blood culture growth, the differential diagnosis criterion, cannot be achieved in all patients, and the results cannot be obtained earlier than 24 h. On the other hand, when attempting to confirm the absence of infection in patients suspected to have sepsis but in fact not having sepsis, serious diagnostic problems arise (3).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic and prognostic value of procalcitonin and sTREM-1 levels in sepsis

Bayram¹,

Tünger²,

Çivi³

et al. 2015

Turk J Med Sci

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Background/aim: Sepsis is still a major cause of morbidity and mortality despite the improvements in diagnosis and treatment. The aim of this study was to investigate the values of procalcitonin and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in the differential diagnosis of patients with sepsis and noninfectious systemic inflammatory response syndrome (NI-SIRS) and measure their importance in the prognosis of patients with sepsis. Materials and methods:This prospective study included 41 NI-SIRS and 33 sepsis patients hospitalized in Celal Bayar University Hospital, Manisa, Turkey. Blood samples were taken from NI-SIRS patients on days 0 and 3 and from sepsis patients on days 0, 3, 4, 7, and 14. Clinical status of the patients was determined with the SOFA scoring system.Results: The SOFA scoring system and procalcitonin and sTREM-1 measurements were significant in the differential diagnosis of sepsis and NI-SIRS patients. The SOFA scoring system was considered the most important indicator in determining the prognosis of sepsis patients. Procalcitonin and sTREM-1 levels increased progressively in nonsurvivors and decreased in survivors, but changes were statistically insignificant. Conclusion:In the differentiation of sepsis and NI-SIRS, and evaluation of the prognosis of sepsis, combined measurements of procalcitonin and sTREM-1 levels are important.

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Rapid diagnosis of sepsis

Cited by 137 publications

References 98 publications

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Comparison of Procalcitonin and C-reactive Protein in Differential Diagnosis of Sepsis and Severe Sepsis in Emergency Department

Diagnostic and prognostic value of procalcitonin and sTREM-1 levels in sepsis

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