title: Emerging infection and sepsis biomarkers: will they change current therapies?
abstract: Sepsis is a heterogeneous syndrome characterized by both immune hyperactivity and relative immune suppression. Biomarkers have the potential to improve recognition and management of sepsis through three main applications: diagnosis, monitoring response to treatment, and stratifying patients based on prognosis or underlying biological response.
  
  
  
  This review focuses on specific examples of well-studied, evidence-supported biomarkers, and discusses their role in clinical practice with special attention to antibiotic stewardship and cost-effectiveness. Biomarkers were selected based on availability of robust prospective trials and meta-analyses which supported their role as emerging tools to improve the clinical management of sepsis. Expert commentary: Great strides have been made in candidate sepsis biomarker discovery and testing, with the biomarkers in this review showing promise. Yet sepsis remains a dynamic illness with a great degree of biological heterogeneity - heterogeneity which may be further resolved by recently discovered gene expression-based endotypes in septic shock.
authors.affiliation: a Department of Pediatrics, Division of Critical Care Medicine , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Jacobs
authors.affiliation: b Critical Care Medicine , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.
authors.forename: Hector R
authors.initials: HR
authors.lastname: Wong
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis*; D021821:Communicable Diseases, Emerging / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000401:mortality; D019317:Evidence-Based Medicine; D006801:Humans; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000401:mortality
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers
keywords: IL-27; PERSEVERE; Sepsis; bioscore; cfDNA; endotype; immune system; nCD64; presepsin; procalcitonin