Role of Biomarkers in Sepsis Care

Abstract

Sepsis is one of the leading causes of mortality and morbidity, even with the current availability of extended spectrum antibiotics and advanced medical care. Biomarkers offer a tool in facilitating early diagnosis, in identifying patient populations at high risk of complications, and in monitoring progression of the disease, which are critical assessments for appropriate therapy and improvement in patient outcomes. Several biomarkers are already available for clinical use in sepsis; however, their effectiveness in many instances is limited by the lack of specificity and sensitivity to characterize the presence of an infection and the complexity of the inflammatory and immune processes, and to stratify patients into homogenous groups for specific treatments. Current advances in molecular techniques have provided new tools facilitating the discovery of novel biomarkers, which can vary from metabolites and chemical products present in body fluids to genes and proteins in circulating blood cells. The purpose of this review is to examine the current status of sepsis biomarkers, with special emphasis on emerging markers, which are undergoing validation and may transition into clinical practice for their informative value in diagnosis, prognosis or response to therapy. We will also discuss the new concept of combination biomarkers and biomarker risk models, their existing challenges, and their potential use in the daily management of the sepsis patients.

Ang-2, Tie-2, and Ang-2/Tie-2 ratio serum levels as diagnostic and prognostic biomarkers of sepsis in critically ill patients

“…The advantage of PCT is augmented by the early increase in serum levels after infectious challenge, within the first three to six hours [29,30,35].…”

“…In sepsis PCT levels are mostly greater than 1-2 µg/L and often reach values over ten µg/L, or higher in individual cases, enabling the diagnostic differentiation between different clinical conditions from bacterial infection [29,30,35].…”

“…All five patients were ventilated mechanically, the lungs being the site of infection. Ventilator acquired pneumonias are a common cause worldwide of ICU infections [30,31,32]. The positive cultures with Staphylococcus Epidermidis were deemed to be due to contamination during the blood sample handling and excluded from positive blood culture patients.…”

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

“…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).…”

“…It is a useful marker used in the determination of the severity of the infection, the prediction of prognosis, and monitoring the response to the treatment (5,7).…”