Biomarkers and newer laboratory investigations in the diagnosis of sepsis

J R Coll Physicians Edinb. 2019 Sep;49(3):207-216. doi: 10.4997/JRCPE.2019.308.

Abstract

Sepsis is a major cause of death in hospitalised patients accounting for mortality rates as high as 60% and, hence, is called 'a hidden public health disaster'. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis is not a disease but is a clinical syndrome, where the initial features are nonspecific resulting in delayed diagnosis. Lack of specific laboratory tests to diagnose the syndrome adds to the diagnostic confusion. Failure to identify sepsis in the early stages itself delays effective treatment resulting in high morbidity and mortality. Various biomarkers and newer laboratory tests help to address these issues. However, to date there is no ideal test to diagnose sepsis. The most commonly used markers are C-reactive protein (CRP) and procalcitonin (PCT). There are around 180 biomarkers reported to be useful in sepsis. In addition to CRP and PCT, various emerging laboratory markers, such as like serum amyloid A, soluble triggering receptor expressed on myeloid cell-1, mannan and antimannan antibodies, and interferon γ inducible protein-10 etc., have been reviewed and their clinical usefulness discussed in this paper.

Keywords: C-reactive protein; biomarkers; bioscore; procalcitonin; sepsis.

Publication types

  • Review

MeSH terms

  • Acute-Phase Proteins
  • Adrenomedullin / blood
  • Antibodies, Fungal / blood
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Carrier Proteins / blood
  • Complement C5a / analysis
  • Cytokines / blood
  • HMGB1 Protein / blood
  • Hepcidins / blood
  • Hexosaminidases / blood
  • Humans
  • Lipopolysaccharide Receptors / blood
  • Mannans / immunology
  • Membrane Glycoproteins / blood
  • Neutrophils / metabolism
  • Peptide Fragments / blood
  • Receptors, IgG / blood
  • Sepsis / blood
  • Sepsis / diagnosis*
  • Serum Amyloid A Protein / analysis
  • Serum Amyloid P-Component / analysis
  • Triggering Receptor Expressed on Myeloid Cells-1 / blood
  • Urokinase-Type Plasminogen Activator / blood

Substances

  • Acute-Phase Proteins
  • Antibodies, Fungal
  • Biomarkers
  • Carrier Proteins
  • Cytokines
  • HMGB1 Protein
  • HMGB1 protein, human
  • Hepcidins
  • Lipopolysaccharide Receptors
  • Mannans
  • Membrane Glycoproteins
  • Peptide Fragments
  • Receptors, IgG
  • Serum Amyloid A Protein
  • Serum Amyloid P-Component
  • TREM1 protein, human
  • Triggering Receptor Expressed on Myeloid Cells-1
  • lipopolysaccharide-binding protein
  • presepsin protein, human
  • Adrenomedullin
  • PTX3 protein
  • Complement C5a
  • C-Reactive Protein
  • Hexosaminidases
  • chitotriosidase
  • Urokinase-Type Plasminogen Activator