Laboratory Diagnosis of Sepsis? No SIRS, Not Just Yet

Abstract

In order to maximize the benefit of prompt antimicrobial therapy and avoid the risk associated with inappropriate use of antimicrobial agents, patients with suspected sepsis must be rapidly differentiated from patients with systemic inflammatory response syndrome (SIRS). In combination with standard microbiological testing, a number of biomarkers have been recently evaluated for this purpose, and the performance characteristics of the most promising of these are reviewed.

FIG 1

Venn diagram illustrating that sepsis lies at the intersection of infection and the systemic infection response syndrome (SIRS). Culture-proven infection is not a requirement, but a high clinical suspicion of infection suffices to define sepsis. The source of infection need not be blood/bacteremia but could be respiratory or abdominal or involve other sites. Many other noninfectious clinical conditions can lead to a clinical picture of SIRS, including major trauma or surgery, extensive burns, and pancreatitis, to name a few.