Novel biomarkers for sepsis: A narrative review

Larsen, Frederik Fruergaard; Petersen, John Asger

doi:10.1016/j.ejim.2017.09.030

Cited by 123 publications

(97 citation statements)

References 48 publications

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“…32,33 PCT is a prohormone or precursor to calcitonin (the hormone that regulates calcium concentration) and it is not normally released into the bloodstream unless stimulated by infection and inflammation. 34,35 PCT production is stimulated directly by bacterial endotoxins or indirectly by inflammatory mediators, and rises quickly after the onset of infection. [35][36][37] PCT levels increase significantly in systemic infections, such as sepsis, thus it is a reliable biomarker for early diagnosis of sepsis and/or for response to therapy.…”

Section: Newer Biomarkers Of Infection and Inflammation: Sepsismentioning

confidence: 99%

Biomarkers of Infection and Inflammation

Chatterjee¹,

Butina²

2020

Clin Lab Sci

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Biomarkers, or biological markers, have been tested in the clinical laboratory for decades. More recently, there has been a surge in research studies aimed at identifying biomarkers of infection and inflammation. One of the foremost motivators in this expansion of research is the quest to find ideal biomarkers for sepsis. Traditional, yet still relevant, laboratory markers of infection and inflammation consist of the white blood cell count, erythrocyte sedimentation rate, and Creactive protein. Newer biomarkers that are currently available in the clinical laboratory and used for the evaluation of sepsis include lactate and procalcitonin, while two promising emergent biomarkers for the evaluation of sepsis, pentraxin 3 and presepsin, are presented. Beyond sepsis, promising emergent biomarkers for chronic wound infections, pneumonia, and invasive fungal infections are also discussed.

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Section: Newer Biomarkers Of Infection and Inflammation: Sepsismentioning

confidence: 99%

Biomarkers of Infection and Inflammation

Chatterjee¹,

Butina²

2020

Clin Lab Sci

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“…Affected patients show heterogeneous symptoms, response to treatment, and outcomes. 3,6,7 Currently, no gold standard exists for detecting sepsis due to blood stream infection, which would be a key factor for targeted therapy and may improve survival. There are important limitations to the use of conventional diagnostic modalities such as blood cultures and inflammatory blood markers (i.e., C-reactive protein, white blood cells) in patients with clinical suspicion of infection and sepsis in the ICU setting.…”

Section: Diagnostic Biomarkers For Infections In the Icumentioning

confidence: 99%

Biomarkers of Infection: Are They Useful in the ICU?

Heilmann

Gregoriano

Schuetz

2019

Semin Respir Crit Care Med

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Biomarkers are increasingly used in patients with serious infections in the critical care setting to complement clinical judgment and interpretation of other diagnostic and prognostic tests. The main purposes of such blood markers are (1) to improve infection diagnosis (i.e., differentiation between bacterial vs. viral vs. fungal vs. noninfectious), (2) to help in the early risk stratification and thus provide prognostic information regarding the risk for mortality and other adverse outcomes, and (3) to optimize antibiotic tailoring to individual needs of patients (“antibiotic stewardship”).Especially in critically ill patients, in whom sepsis is a major cause of morbidity and mortality, rapid diagnosis is desirable to start timely and specific treatment.Besides some biomarkers, such as procalcitonin, which is well established and has shown positive effects in regard to utilization of antimicrobials and clinical outcomes, there is a growing number of novel markers from different pathophysiological pathways, where the final proof of an added value to clinical judgment and ultimately clinical benefit to patients is still lacking.Without a doubt, the addition of blood biomarkers to clinical medicine has had a strong impact on the way we care for patients today. Recent trials show that as an adjunct to other clinical and laboratory parameters these markers provide important information about risks for bacterial infection and resolution of infection. Moreover, biomarkers can help to optimize management of patients with serious illness in the intensive care unit, thereby offering more individualized treatment courses with overall improvements in clinical outcomes.

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“…An early diagnosis should be the goal in management of SIRS patients, allowing starting adequate treatment in an early stage …”

Section: Introductionmentioning

confidence: 99%

“…13 An early diagnosis should be the goal in management of SIRS patients, allowing starting adequate treatment in an early stage. 14,15 Our aim was to compare PON-1 activity in sick horses classified as SIRS-positive or SIRS-negative, as proposed by others, 16 and to investigate the performances of PON-1 activity in terms of sensitivity, specificity, and likelihood ratio in identifying SIRS-positive and negative horses.…”

Section: Introductionmentioning

confidence: 99%

Paraoxonase‐1 activity evaluation as a diagnostic and prognostic marker in horses and foals

Ruggerone

Paltrinieri

Giordano

et al. 2020

Veterinary Internal Medicne

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Background In several species, paraoxonase‐1 (PON‐1) decreases during inflammation, because of the presence of oxidative stress; its measurement recently has been validated in horses, but its role as a clinical biomarker is unknown. Objectives To evaluate sensitivity, specificity and likelihood ratio of PON‐1 activity to identify systemic inflammatory response syndrome (SIRS)‐positive horses or horses with a poor prognosis. Animals One hundred seventy‐two blood samples from 58 sick horses from 3 different veterinary hospitals. Methods In a cross‐sectional study, PON‐1 activity was measured upon admission and at 24‐hour intervals until discharge or death, and results were analyzed based on SIRS status and outcome. Results No statistically significant difference was found in median PON‐1 activity between SIRS and non‐SIRS cases or between survivors and non‐survivors except for mares, in which PON‐1 activity was significantly lower in SIRS‐positive horses (P = .05). The sensitivity of PON‐1 activity in identifying horses with SIRS or negative outcome was low (0.0%‐46.2% depending on the examined group) but its specificity was high (87.0%‐100.0%). However, when PON‐1 is low, the likelihood of death is 2.40‐3.89 times higher than the likelihood of survival. Repeated measurement of PON‐1 after treatment does not predict outcome. Conclusions and Clinical Importance Evaluation of PON‐1 activity in horses with inflammation might be advisable in the future, but only low activity at admission may be relevant in predicting SIRS or negative outcome.

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Novel biomarkers for sepsis: A narrative review

Cited by 123 publications

References 48 publications

Biomarkers of Infection and Inflammation

Biomarkers of Infection and Inflammation

Biomarkers of Infection: Are They Useful in the ICU?

Paraoxonase‐1 activity evaluation as a diagnostic and prognostic marker in horses and foals

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