Speaker: Giuseppe Lippi
Moderator: Dirk Roggenbuck
Recorded on 22nd January

Abstract: Sepsis is a severe, often life-threatening, condition developing when the organism’s response to an infection triggers a paramount biological effect, which finally generate injuries to its own tissues and organs, up to septic shock, multi-organ failure (MOF) and death. Evidence has been provided that the measurement of some biomarkers in serum or plasma may have clinical values for diagnosing and monitoring sepsis. Consensus has now been reached that procalcitonin is the biomarker for which the most solid evidence has been garnered, that whatever sepsis biomarkers shall always be available on prescription, that test results should always be interpreted according to clinical data, and that test ordering should follow specific biomarker’s kinetics. Sepsis biomarkers assessment may be sometimes combined for diagnosing sepsis. In such case, the combination of procalcitonin with C reactive protein (CRP) or presepsin is the most widely suggested. Sepsis biomarkers should be integrated into diagnostic threshold, prioritizing the high negative predictive value and based on analytically sensitive techniques. Evidence is also strongly emerging that some of these biomarkers, especially procalcitonin and presepsin, may retain clinical usefulness for antibiotic stewardship, and that serial testing shall be set according to biomarker’s kinetics. The assessment of biomarkers other than procalcitonin, presepsin and CRP is now discouraged, at least until stronger evidence will be published. Molecular biology techniques are also emerging as potential alternatives for rapid etiological diagnosis of infections. Further refinements of molecular assays would probably help overcoming the current limitations of their diagnostic performance.