Biomarkers in sepsis

• Published in: Clinica chimica acta 2024-08, Vol.562, p.119891, Article 119891
• Main Authors: Saxena, Juhi, Das, Sarvjeet, Kumar, Anshu, Sharma, Aditi, Sharma, Lalit, Kaushik, Sanket, Kumar Srivastava, Vijay, Jamal Siddiqui, Arif, Jyoti, Anupam
• Format: Article
• Language: English
• Subjects: Antimicrobial stewardship; Biomarkers; Diagnosis; Risk stratification; Sepsis; Transcriptional diagnostics
• ISSN: 0009-8981; 1873-3492; 1873-3492
• DOI: 10.1016/j.cca.2024.119891

•Biomarkers are crucial for diagnosing and managing sepsis.•Early identification of sepsis improves survival rates.•Biomarkers guide antimicrobial therapy and risk assessment.•Transcriptional diagnostics and sequencing offer new diagnostic insights. Sepsis is a life-threatening condition characterized by dysregulated host response to infection leading to organ dysfunction. Despite advances in understanding its pathology, sepsis remains a global health concern and remains a major contributor to mortality. Timely identification is crucial for improving clinical outcomes, as delayed treatment significantly impacts survival. Accordingly, biomarkers play a pivotal role in diagnosis, risk stratification, and management. This review comprehensively discusses various biomarkers in sepsis and their potential application in antimicrobial stewardship and risk assessment. Biomarkers such as white blood cell count, neutrophil to lymphocyte ratio, erythrocyte sedimentation rate, C-reactive protein, interleukin-6, presepsin, and procalcitonin have been extensively studied for their diagnostic and prognostic value as well as in guiding antimicrobial therapy. Furthermore, this review explores the role of biomarkers in risk stratification, emphasizing the importance of identifying high-risk patients who may benefit from specific therapeutic interventions. Moreover, the review discusses the emerging field of transcriptional diagnostics and metagenomic sequencing. Advances in sequencing have enabled the identification of host response signatures and microbial genomes, offering insight into disease pathology and aiding species identification. In conclusion, this review provides a comprehensive overview of the current understanding and future directions of biomarker-based approaches in sepsis diagnosis, management, and personalized therapy.