Emerging Biosensing Technologies towards Early Sepsis Diagnosis and Management

Bonini, Andrea; Carota, Angela Gilda; Poma, Noemi; Vivaldi, Federico; Biagini, Denise; Bottai, Daria; Lenzi, Alessio; Tavanti, Arianna; Francesco, Fabio Di; Lomonaco, T

doi:10.3390/bios12100894

Cited by 7 publications

(5 citation statements)

References 93 publications

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“…Among different biomarkers which have been proposed to predict sepsis or bacteremia, the main attributes of successful and effective biomarkers are high sensitivity, specificity, possibility of bed-side monitoring, and financial accessibility ( 20 ). To date, the sepsis biomarkers that commercially available in Japan are CRP, PCT, presepsin and IL-6.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of cell population data with Sysmex XN-series hematology analyzer for culture-proven bacteremia

et al. 2023

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BackgroundCell population data (CPD) parameters related to neutrophils, such as fluorescent light intensity (NE-SFL) and fluorescent light distribution width index (NE-WY), have emerged as potential biomarkers for sepsis. However, the diagnostic implication in acute bacterial infection remains unclear. This study assessed the diagnostic value of NE-WY and NE-SFL for bacteremia in patients with acute bacterial infections, and those associations with other sepsis biomarkers.MethodsPatients with acute bacterial infections were enrolled in this prospective observational cohort study. For all patients, a blood sample, with at least two sets of blood cultures, were collected at the onset of infection. Microbiological evaluation included examination of the blood bacterial load using PCR. CPD was assessed using Automated Hematology analyzer Sysmex series XN-2000. Serum levels of procalcitonin (PCT), interleukin-6 (IL-6), presepsin, and CRP were also assessed.ResultsOf 93 patients with acute bacterial infection, 24 developed culture-proven bacteremia and 69 did not. NE-SFL and NE-WY were significantly higher in patients with bacteremia than in those without bacteremia (p < 0.005, respectively), and were significantly correlated with the bacterial load determined by PCR (r = 0.384 and r = 0.374, p < 0.005, respectively). To assess the diagnostic value for bacteremia, receiver operating characteristic curve analysis was used. NE-SFL and NE-WY showed an area under the curve of 0.685 and 0.708, respectively, while those of PCT, IL-6, presepsin, and CRP were 0.744, 0.778, 0.685, and 0.528, respectively. Correlation analysis showed that the levels of NE-WY and NE-SFL were strongly correlated with PCT and IL-6 levels.ConclusionThis study demonstrated that NE-WY and NE-SFL could predict bacteremia in a manner that may be different from that of other indicators. These findings suggest there are potential benefits of NE-WY/NE-SFL in predicting severe bacterial infections.

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Section: Discussionmentioning

confidence: 99%

Predictive value of cell population data with Sysmex XN-series hematology analyzer for culture-proven bacteremia

et al. 2023

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“… 25 Similarly, point of care biosensors may hold promise for earlier diagnosis of sepsis. 26 Senior clinician champions capable of influencing practice norms, nurses empowered to implement sepsis screening strategies and generate alerts, and regular benchmarked feedback on care compliance and patient outcomes can also improve performance. 10 Finally, the high readmission rate and our novel finding of sepsis-induced accentuation of frailty suggests the need for closer post-discharge follow-up of older patients and, where appropriate, referral to rehabilitation services.…”

Section: Discussionmentioning

confidence: 99%

Recognition and Management of Hospital-Acquired Sepsis Among Older General Medical Inpatients: A Multi-Site Retrospective Study

Barker¹,

Scott²,

Seaton³

et al. 2023

IJGM

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Purpose To assess accuracy of early diagnosis, appropriateness and timeliness of response, and clinical outcomes of older general medical inpatients with hospital-acquired sepsis. Methods Hospital abstracts of inpatient encounters from seven digital Queensland public hospitals between July 2018 and September 2020 were screened retrospectively for diagnoses of hospital-acquired sepsis. Electronic medical records were retrieved and cases meeting selection criteria and classified as confirmed or probable sepsis using pre-specified criteria were included. Investigations and treatments following the first digitally generated alert of clinical deterioration were compared with a best practice sepsis care bundle. Outcome measures comprised 30-day all-cause mortality after deterioration, and unplanned readmissions at 14 days after discharge. Results Of the 169 screened care episodes, 59 comprised probable or confirmed cases of sepsis treated by general medicine teams at the time of initial deterioration. Of these, 43 (72.9%) had no mention of sepsis in the differential diagnosis on first medical review, and only 38 (64%) were managed as having sepsis. Each care bundle component of blood cultures, serum lactate, and intravenous fluid resuscitation and antibiotics was only delivered in approximately 30% of cases, and antibiotic administration was delayed more than an hour in 28 of 38 (73.7%) cases. Conclusion Early recognition of sepsis and timely implementation of care bundles are challenging in older general medical patients. Education programs in sepsis care standards targeting nurses and junior medical staff, closer patient monitoring, and post-discharge follow-up may improve patient outcomes.

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“…Quantification of sepsis biomarkers can greatly facilitate diagnosis [ 58 , 59 ]. Even though the detection of some of them (CRP and PCT, for instance) can be fast, the acquired results lack specificity, as their levels can also rise in non-septic conditions [ 58 ].…”

Section: Sepsis Biomarkersmentioning

confidence: 99%

Challenges and Advances in Biomarker Detection for Rapid and Accurate Sepsis Diagnosis: An Electrochemical Approach

Kumar,

Banaś,

Krukiewicz

2024

Biosensors

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Sepsis is a life-threatening condition with high mortality rates due to delayed treatment of patients. The conventional methodology for blood diagnosis takes several hours, which suspends treatment, limits early drug administration, and affects the patient’s recovery. Thus, rapid, accurate, bedside (onsite), economical, and reliable sepsis biomarker reading of the clinical sample is an emergent need for patient lifesaving. Electrochemical label-free biosensors are specific and rapid devices that are able to perform analysis at the patient’s bedside; thus, they are considered an attractive methodology in a clinical setting. To reveal their full diagnostic potential, electrode architecture strategies of fabrication are highly desirable, particularly those able to preserve specific antibody–antigen attraction, restrict non-specific adsorption, and exhibit high sensitivity with a low detection limit for a target biomarker. The aim of this review is to provide state-of-the-art methodologies allowing the fabrication of ultrasensitive and highly selective electrochemical sensors for sepsis biomarkers. This review focuses on different methods of label-free biomarker sensors and discusses their advantages and disadvantages. Then, it highlights effective ways of avoiding false results and the role of molecular labels and functionalization. Recent literature on electrode materials and antibody grafting strategies is discussed, and the most efficient methodology for overcoming the non-specific attraction issues is listed. Finally, we discuss the existing electrode architecture for specific biomarker readers and promising tactics for achieving quick and low detection limits for sepsis biomarkers.

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Emerging Biosensing Technologies towards Early Sepsis Diagnosis and Management

Cited by 7 publications

References 93 publications

Predictive value of cell population data with Sysmex XN-series hematology analyzer for culture-proven bacteremia

Predictive value of cell population data with Sysmex XN-series hematology analyzer for culture-proven bacteremia

Recognition and Management of Hospital-Acquired Sepsis Among Older General Medical Inpatients: A Multi-Site Retrospective Study

Challenges and Advances in Biomarker Detection for Rapid and Accurate Sepsis Diagnosis: An Electrochemical Approach

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