Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Jun 25;57(7):e00425-19.
doi: 10.1128/JCM.00425-19. Print 2019 Jul.

Diagnosing and Managing Sepsis by Probing the Host Response to Infection: Advances, Opportunities, and Challenges

Affiliations
Review

Diagnosing and Managing Sepsis by Probing the Host Response to Infection: Advances, Opportunities, and Challenges

Ian L Gunsolus et al. J Clin Microbiol. .

Abstract

Sepsis is a major source of mortality and morbidity globally. Accurately diagnosing sepsis remains challenging due to the heterogeneous nature of the disease, and delays in diagnosis and intervention contribute to high mortality rates. Measuring the host response to infection enables more rapid diagnosis of sepsis than is possible through direct detection of the causative pathogen, and recent advances in host response diagnostics and prognostics hold promise for improving outcomes. The current review discusses recent advances in the technologies used to probe the host response to infection, particularly those based on transcriptomics. These are discussed in the context of contemporary approaches to diagnosing and prognosing sepsis, and recommendations are made for successful development and validation of host response technologies.

Keywords: bacteremia; host response; molecular diagnostics; sepsis; viremia.

PubMed Disclaimer

Figures

FIG 1
FIG 1
The presence of infection and severity of illness can be envisioned along orthogonal diagnostic axes. Single-protein or -metabolite sepsis biomarkers face challenges distinguishing acute uncomplicated infections (upper left quadrant) from noninfectious critical illness (lower right quadrant) since available biomarker expression can be increased in both cases.

References

    1. Liu V, Escobar GJ, Greene JD, Soule J, Whippy A, Angus DC, Iwashyna TJ. 2014. Hospital deaths in patients with sepsis from 2 independent cohorts. JAMA 312:90–92. doi:10.1001/jama.2014.5804. - DOI - PubMed
    1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche J-D, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent J-L, Angus DC. 2016. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 315:801–810. doi:10.1001/jama.2016.0287. - DOI - PMC - PubMed
    1. Sinha M, Jupe J, Mack H, Coleman TP, Lawrence SM, Fraley SI. 2018. Emerging technologies for molecular diagnosis of sepsis. Clin Microbiol Rev 31:e00089-17. doi:10.1128/CMR.00089-17. - DOI - PMC - PubMed
    1. Liesenfeld O, Lehman L, Hunfeld K-P, Kost G. 2014. Molecular diagnosis of sepsis: new aspects and recent developments. Eur J Microbiol Immunol (Bp) 4:1–25. doi:10.1556/EuJMI.4.2014.1.1. - DOI - PMC - PubMed
    1. Reinhart K, Bauer M, Riedemann NC, Hartog CS. 2012. New approaches to sepsis: molecular diagnostics and biomarkers. Clin Microbiol Rev 25:609–634. doi:10.1128/CMR.00016-12. - DOI - PMC - PubMed