Current Evidence and Limitation of Biomarkers for Detecting Sepsis and Systemic Infection
Sepsis was recently redefined as a life-threatening disease involving organ dysfunction caused by a dysregulated host response to infection. Biomarkers play an important role in early detection, diagnosis, and prognostication. We reviewed six promising biomarkers for detecting sepsis and systemic in...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-11-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/8/11/494 |
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| author | Shang-Kai Hung Hao-Min Lan Shih-Tsung Han Chin-Chieh Wu Kuan-Fu Chen |
| author_facet | Shang-Kai Hung Hao-Min Lan Shih-Tsung Han Chin-Chieh Wu Kuan-Fu Chen |
| author_sort | Shang-Kai Hung |
| collection | DOAJ |
| description | Sepsis was recently redefined as a life-threatening disease involving organ dysfunction caused by a dysregulated host response to infection. Biomarkers play an important role in early detection, diagnosis, and prognostication. We reviewed six promising biomarkers for detecting sepsis and systemic infection, including C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), CD64, presepsin, and sTREM-1. Among the recent studies, we found the following risks of bias: only a few studies adopted the random or consecutive sampling strategy; extensive case-control analysis, which worsened the over-estimated performance; most of the studies used post hoc cutoff values; and heterogeneity with respect to the inclusion criteria, small sample sizes, and different quantitative synthesis methods applied in meta-analyses. We recommend that CD64 and presepsin should be considered as the most promising biomarkers for diagnosing sepsis. Future studies should enroll a larger sample size with a cohort rather than a case-control study design. A random or consecutive study design with a pre-specified laboratory threshold, consistent sampling timing, and an updated definition of sepsis will also increase the reliability of the studies. Further investigations of appropriate specimens, testing assays, and cutoff levels for specific biomarkers are also warranted. |
| first_indexed | 2024-03-10T14:55:00Z |
| format | Article |
| id | doaj.art-74a83e0ee81d4668b719e9d6a266dd9a |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-10T14:55:00Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-74a83e0ee81d4668b719e9d6a266dd9a2023-11-20T20:39:54ZengMDPI AGBiomedicines2227-90592020-11-0181149410.3390/biomedicines8110494Current Evidence and Limitation of Biomarkers for Detecting Sepsis and Systemic InfectionShang-Kai Hung0Hao-Min Lan1Shih-Tsung Han2Chin-Chieh Wu3Kuan-Fu Chen4Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou 333, TaiwanDepartment of Education, Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDepartment of Emergency Medicine, Chang Gung Memorial Hospital, Linkou 333, TaiwanClinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan 333, TaiwanClinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan 333, TaiwanSepsis was recently redefined as a life-threatening disease involving organ dysfunction caused by a dysregulated host response to infection. Biomarkers play an important role in early detection, diagnosis, and prognostication. We reviewed six promising biomarkers for detecting sepsis and systemic infection, including C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), CD64, presepsin, and sTREM-1. Among the recent studies, we found the following risks of bias: only a few studies adopted the random or consecutive sampling strategy; extensive case-control analysis, which worsened the over-estimated performance; most of the studies used post hoc cutoff values; and heterogeneity with respect to the inclusion criteria, small sample sizes, and different quantitative synthesis methods applied in meta-analyses. We recommend that CD64 and presepsin should be considered as the most promising biomarkers for diagnosing sepsis. Future studies should enroll a larger sample size with a cohort rather than a case-control study design. A random or consecutive study design with a pre-specified laboratory threshold, consistent sampling timing, and an updated definition of sepsis will also increase the reliability of the studies. Further investigations of appropriate specimens, testing assays, and cutoff levels for specific biomarkers are also warranted.https://www.mdpi.com/2227-9059/8/11/494sepsisbiomarkerC-reactive proteinprocalcitoninpresepsininterleukin-6 |
| spellingShingle | Shang-Kai Hung Hao-Min Lan Shih-Tsung Han Chin-Chieh Wu Kuan-Fu Chen Current Evidence and Limitation of Biomarkers for Detecting Sepsis and Systemic Infection Biomedicines sepsis biomarker C-reactive protein procalcitonin presepsin interleukin-6 |
| title | Current Evidence and Limitation of Biomarkers for Detecting Sepsis and Systemic Infection |
| title_full | Current Evidence and Limitation of Biomarkers for Detecting Sepsis and Systemic Infection |
| title_fullStr | Current Evidence and Limitation of Biomarkers for Detecting Sepsis and Systemic Infection |
| title_full_unstemmed | Current Evidence and Limitation of Biomarkers for Detecting Sepsis and Systemic Infection |
| title_short | Current Evidence and Limitation of Biomarkers for Detecting Sepsis and Systemic Infection |
| title_sort | current evidence and limitation of biomarkers for detecting sepsis and systemic infection |
| topic | sepsis biomarker C-reactive protein procalcitonin presepsin interleukin-6 |
| url | https://www.mdpi.com/2227-9059/8/11/494 |
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