Table 10

Biomarkers that have been assessed for use in the diagnosis of sepsis

Sepsis biomarker

Clinical study

Type of measurement

Outcome


1

aPTT** [35]

C

c

High negative predictive value

2

CD11b*** [33]

B

s

Higher values in neonates with sepsis than in those with possible infection

3

CD25 [87]

A

s

Distinguished between sepsis and SIRS

4

CD64*** [32,287]

C

s

Low sensitivity and specificity to distinguish between viral and bacterial infections

5

Complement (C3, C4, C5a) [219]

B

s

Distinguished between sepsis and SIRS

6

EA complex [230]

C

s

Diagnosis of sepsis, increased earlier than CRP

7

ELAM-1 (cellular and soluble) [129]

C(s)

c

Increased in trauma patients with sepsis compared with no sepsis

8

Endocan [127]

B

s

Distinguished between sepsis and SIRS

9

E-Selectin (cellular and soluble) [136]

B

s

Distinguished between sepsis and SIRS

10

Fibrin degradation products [36]

B

s

High negative predictive value

11

Gas6 [241]

B

s

Higher values in patients with severe sepsis compared with patients with organ failure but no sepsis

12

G-CSF [237]

C

s

Distinguished between sepsis and SIRS

13

Gelsolin [238]

B(s)

c

Higher in septic patients compared with patients without sepsis

14

IL-1 receptor antagonist [55]

C

s

Early diagnosis of sepsis before symptoms in newborns

15

IL-8* [61]

C

s

Higher in septic neutropenic patients compared with febril neutropenic patients without sepsis

16

IL-10 [65]

A

s

Higher in septic shock compared with cardiogenic shock

17

IL-12*** [29]

C

s

Diagnosis of sepsis in pediatric patients

18

IL-18 [70]

B(s)

s

Distinguished between Gram-positive and Gram-negative sepsis. Higher in trauma patients with sepsis than in those without

19

IP-10*** [30]

C

s

Early diagnosis of sepsis in newborns

20

Laminin [38]

A

s

Distinguished between Candida sepsis and bacterial sepsis

21

LBP [204]

C

s

Distinguished between Gram-positive sepsis and Gram-negative

22

MCP-1 [61]

C

s

Distinguished between sepsis and SIRS in neutropenic pediatric patients

23

NO, nitrate, nitrite [161]

B

s

Higher in septic shock compared with cardiogenic shock

24

Osteopontin [75]

B

s

Distinguished between sepsis and SIRS

25

PAI-1 [118]

B

s

Higher in patients with sepsis and DIC compared with no-septic patients with DIC

26

Pentraxin 3 [207]

C

s

Distinguished between septic shock and SIRS

27

Peptidoglycan [262]

B(s)

c

Higher in postoperative patients with infection compared with no-infected postoperative patients

28

pFN [270]

B

s

Distinguished between sepsis and SIRS

29

PLA2-II (soluble)*** [31]

B

s

Distinguished between bacteremic and non-bacteremic infections

30

Serum lysozyme (enzyme activity) [258]

B

s

Distinguished between sepsis and organ rejection in transplanted patients

31

ST2 (soluble) [108]

A

s

Higher in septic patients compared with those with no sepsis

32

Surfactant protein (A, B, C, D) [192]

B

s

Early diagnosis of ARDS in septic patients

33

TREM-1 (soluble) [288,289]

C

s

Distinguished between sepsis and SIRS, diagnosed pneumonia

34

Troponin [193]

B

s

Diagnosis of myocardial dysfunction in septic patients


*sensitivity and specificity of less than 90%; **sensitivity of more than 90% but specificity of less than 90%; ***sensitivity and specificity more than 90%; A, Clinical study with less than 20 patients; B, Clinical study with 20 to 50 patients; C, Clinical study with more than 50 patients; (s), surgical patients only; (m), medical patients only; s, single value; c, values over time.

aPTT: activated partial thromboplastin time; ARDS: acute respiratory distress syndrome; CRP: C-reactive protein; DIC: disseminated intravascular coagulopathy; EA: elastase alpha 1-proteinase inhibitor; ELAM: endothelial leukocyte adhesion molecule; G-CSF: granulocyte colony-stimulating factor; IP: interferon-induced protein; LBP: lipopolysaccharide-binding protein; MCP: monocyte chemotactic protein; NO: nitric oxide; PAI: plasminogen activator inhibitor; pFN: plasma fibronectin; PLA2: phospholipase A2; SIRS: systemic inflammatory response syndrome; TREM: triggering receptor expressed on myeloid cells.

Pierrakos and Vincent Critical Care 2010 14:R15   doi:10.1186/cc8872

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