Recent Scenario of Diagnostic and Prognostic Biomarkers of Sepsis in Clinical Practice and the Role of Multi-marker Approach: An Update.

Abstract: Despite extensive work done in the field of sepsis biomarkers; still, there is no consensus on which parameter could be considered as an ideal biomarker for sepsis diagnosis. This review aims to look into the existing biomarkers of clinical utility which are currently being used for sepsis diagnostics along with their advantages and disadvantages. We also provide an insight into the usefulness of a multi-marker approach to diagnosing sepsis and what could be the future direction. A literature review was conducted and four search engines such as PubMed, Scopus, Google Scholar, and Research Gate were used for data mining. Three clinically relevant markers for sepsis diagnosis such as procalcitonin (PCT), prespsin, and pentraxin-3 reviewed critically. Articles were also reviewed for the assessment of a multi-marker approach. Overall more than 100 research papers were found to be eligible for this review. Currently, most of the studies are using a chemiluminescent immunoassay-based PCT as a diagnostic method for sepsis. This method has been standardized all over the world, along with traditional markers such as C-reactive protein (CRP) and highly sensitive-CRP. But now, studies are also being conducted on presepsin and pentraxin-3 which are more sensitive and specific for early diagnosis of sepsis. Despite there being literature on presepsin and pentraxin-3, but due to a lack of standardization for assay methods and the costs involved, both parameters are still a long way in finding space in the routine clinical practice. More efforts should be made to combine several markers and develop an algorithm which can overcome the shortcomings of these markers.