Biomarkers as rapid screening tests for the detection of sepsis

BACKGROUND AND OBJECTIVESThe infection in blood stream, known as sepsis, is one of the most critical infections which needs immediate detection and subsequent medical treatments. The routine microbiological tests are time consuming. So, using a set of biomolecules named as “panel of biomarkers” is an alternative and rapid way in order to diagnosis of infection. In this review, we aimed to describe some important biomarkers for the screening of sepsis.MATERIALS AND METHODSAvailable international databases, Google scholar, Pubmed and Springer link were explored. The given keywords by Medical Subject Headings (MeSH) such as “Biomarkers” and “Sepsis” were also used in searching papers. Finally, the results have been limited to last ۱۰ years, from ۲۰۱۳ to ۲۰۲۳, and related articles were analyzed.RESULTS AND DISCUSSIONThe findings exhibit that the biomarkers of sepsis are mainly classified in two categories of general and specific biomarkers. General biomarkers are Erythrocyte Sedimentation Rate (ESR), white blood cells count and Ferritin which all have low-sensitivity in diagnosis of sepsis. The higher sensitivity and specificity are associated to specific biomarkers which categorized in five groups: Acute-phase proteins (Procalcitonin (PCT), C-reactive protein (CRP), lipopolysaccharide-binding protein (LBP), etc.), cytokines (Il-۱, Il-۶, Il-۸ and TNF-ɑ), coagulation biomarkers (antithrombin, proteins C and S, D-dimers, etc.), complement proteins (C۳b and C۵a) and lastly, soluble receptors (sTREM-۱ and suPAR). Among all of these biomarkers, procalcitonin was the most important and useful biomarker, and it has its effectiveness in cooperation with some other selective biomolecules such as CRP and sTREM-۱.CONCLUSIONNone of the mentioned biomarkers is definitive and applicable alone. Thus, a panel of biomolecules is necessary for early diagnosis of sepsis and subsequently, starting the first line wide-spectrum antibiotics to prevent the expansion of infection until the exact identification and antibiogram testing results are obtained.

کلیدواژه ها:

Sepsis ، Biomarkers ، Acute-phase proteins ، Cytokines ، Blood coagulation factors ، Complement system proteins