Diagnostics

Research

Jump to: Review

17 pages, 2789 KB

Open AccessArticle

The Sepsis ImmunoScore Predicts Sepsis, Mortality, and Deterioration Better than Clinical Scores and Widely Available Biomarkers

by Gregory L. Watson, Lincoln C. Updike, Carlos G. López-Espina, Akhil Bhargava, Lee A. Schmalz, Shah Khan, Dennys S. Urdiales, Matthew D. Sims, Ashok V. Palagiri, Adrian D. Haimovich, Alon Dagan, Benjamin P. Davis, Karen C. White, Paul A. Gurbel, Stockton M. Mayer, Anwaruddin Syed, Sihai Dave Zhao, Ruoqing Zhu, Rashid Bashir, Nathan I. Shapiro and Bobby Reddy, Jr. Show full author list Hide full author list

Diagnostics 2026, 16(13), 1962; https://doi.org/10.3390/diagnostics16131962 - 24 Jun 2026

Viewed by 334

Abstract

Background: Early and accurate risk stratification of patients suspected of serious infection is essential for improving outcomes, but existing diagnostic and predictive tools have limited accuracy. The objective was to compare the performance of an FDA-authorized AI diagnostic test, the Sepsis ImmunoScore, against [...] Read more.

Background: Early and accurate risk stratification of patients suspected of serious infection is essential for improving outcomes, but existing diagnostic and predictive tools have limited accuracy. The objective was to compare the performance of an FDA-authorized AI diagnostic test, the Sepsis ImmunoScore, against widely available biomarkers and clinical tools for diagnosis of sepsis and prediction of in-hospital mortality and intensive care unit (ICU) admission. Methods: This multicenter observational study included 6027 adult patients suspected of infection across 7 U.S. hospital sites. The Sepsis ImmunoScore’s predictive performance was compared to the sequential organ failure assessment (SOFA) score, procalcitonin (PCT), C-reactive protein (CRP), Systemic Inflammatory Response Syndrome (SIRS) score, National Early Warning Score (NEWS), and quick SOFA (qSOFA). Primary outcomes included sepsis as defined by Sepsis-3 criteria, in-hospital mortality, and ICU admission. Predictive accuracy was assessed using area under the receiver operating characteristic curve (AUC), and 95% confidence intervals were generated and hypothesis testing conducted using the bootstrap method. Results: The Sepsis ImmunoScore demonstrated statistically significant superior performance across all outcomes. For sepsis prediction, the Sepsis ImmunoScore achieved an AUC of 0.82, compared to SOFA (0.72), procalcitonin (PCT) (0.70), C-reactive protein (CRP) (0.61), SIRS (0.59), NEWS (0.69), and qSOFA (0.67). For in-hospital mortality prediction, the Sepsis ImmunoScore achieved an AUC of 0.80, outperforming SOFA (0.72), PCT (0.67), CRP (0.58), SIRS (0.60), NEWS (0.72), and qSOFA (0.69). For ICU admission, the Sepsis ImmunoScore reached an AUC of 0.74, superior to SOFA (0.63), PCT (0.64), CRP (0.54), SIRS (0.60), NEWS (0.70), and qSOFA (0.65). All differences between the Sepsis ImmunoScore and comparators were statistically significant. Conclusions: The Sepsis ImmunoScore significantly improved predictive accuracy for sepsis, in-hospital mortality, and ICU admission compared to six conventional clinical scores and biomarkers. This AI-based tool may enhance risk stratification and clinical decision-making, potentially leading to more timely sepsis interventions and improved outcomes. Full article

(This article belongs to the Special Issue Diagnosis and Prognosis of Sepsis)

► Show Figures

Figure 1

15 pages, 1614 KB

Open AccessArticle

A Comparative Evaluation of SIRS, NEWS2, SOFA, and the Novel SOFA-2 Score for Sepsis Classification Agreement and Outcome Prediction

by Jing Qin, Yuan Yan, Chao Wang, Xingyu Tao, Ziyi Wu, Bin Liu and Bailin Niu

Diagnostics 2026, 16(11), 1579; https://doi.org/10.3390/diagnostics16111579 - 23 May 2026

Viewed by 481

Abstract

Background: Sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, remains a leading cause of death worldwide. Its diagnostic criteria have evolved from Sepsis-1 (SIRS) to Sepsis-3 (SOFA). The recent introduction of the SOFA-2 score, an update to [...] Read more.

Background: Sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, remains a leading cause of death worldwide. Its diagnostic criteria have evolved from Sepsis-1 (SIRS) to Sepsis-3 (SOFA). The recent introduction of the SOFA-2 score, an update to the original SOFA, warrants validation in specific patient populations and against other established scoring systems. This study aims to compare the performance of SIRS, NEWS2, SOFA, and the newly proposed SOFA-2 in the classification agreement and prognostic performance for sepsis in a cohort of patients with suspected infection. Methods: This retrospective study enrolled adults with suspected infection admitted to a tertiary emergency center (January 2024–February 2025). SIRS, NEWS2, SOFA, and SOFA-2 scores were calculated from admission data. Patients were stratified using established thresholds (SIRS ≥ 2, NEWS2 ≥ 5, SOFA ≥ 2, SOFA-2 ≥ 2). Concordance with Sepsis-3 (SOFA ≥ 2) and prognostic accuracy for 28-day mortality were evaluated using AUROC analysis. Score distributions and organ dysfunction patterns were compared. Results: Of 562 screened patients, 516 were included. For sepsis classification agreement, SOFA-2 showed excellent agreement with SOFA (kappa = 0.923) and higher specificity than SIRS and SOFA. For 28-day mortality prediction, SOFA-2 showed the numerically highest AUC (0.863, 95% CI: 0.830–0.892), demonstrating slightly better discrimination than SOFA (AUC:0.854, 95% CI: 0.820–0.883). Pairwise DeLong tests indicated no significant differences between SOFA-2 and SOFA (p = 0.160). At optimal cutoffs, SOFA-2 demonstrated higher specificity (89.08% vs. SOFA 78.59% vs. NEWS2 76.87% vs. SIRS 41.33%), while SOFA showed higher sensitivity (81.63% vs. SOFA-2 73.47%). Increasing SOFA-2 scores strongly correlated with higher in-hospital mortality and longer ICU stay (both p < 0.001). SOFA-2 reclassified respiratory and cardiovascular dysfunction with higher thresholds and greater granularity than SOFA. Conclusions: Based on our dataset, SOFA-2 demonstrates high diagnostic alignment with Sepsis-3 classification and higher specificity for mortality prediction, with slightly better discrimination compared to SOFA, NEWS2, and SIRS. While its slightly lower sensitivity may limit early risk stratification in some patients, its strong prognostic performance supports its utility for risk stratification. Multicenter studies are warranted to determine its role in future sepsis definitions. Full article

(This article belongs to the Special Issue Diagnosis and Prognosis of Sepsis)

► Show Figures

Figure 1

19 pages, 690 KB

Open AccessArticle

Prognostic Value of 48-Hour Biomarker Reassessment Beyond Admission SOFA for 28-Day Mortality in Sepsis

by Norberth-Istvan Varga, Adela Benea, Vasile Hachi, Flavia Ignuta, Madalina-Ianca Suba, Mirela Turaiche, Maria Daniela Mot and Florin George Horhat

Diagnostics 2026, 16(10), 1522; https://doi.org/10.3390/diagnostics16101522 - 18 May 2026

Viewed by 354

Abstract

Background/Objectives: Sepsis is clinically dynamic, and isolated admission biomarker values may insufficiently capture early biological evolution after treatment initiation. This study evaluated whether routine biomarker reassessment at approximately 48 h provides incremental prognostic information beyond admission Sequential Organ Failure Assessment (SOFA) score [...] Read more.

Background/Objectives: Sepsis is clinically dynamic, and isolated admission biomarker values may insufficiently capture early biological evolution after treatment initiation. This study evaluated whether routine biomarker reassessment at approximately 48 h provides incremental prognostic information beyond admission Sequential Organ Failure Assessment (SOFA) score for 28-day mortality in sepsis. The analysis was framed as an exploratory 48 h landmark prognostic assessment among patients who were alive and had complete biomarker reassessment data at 48 ± 6 h. Methods: We conducted a prospective single-center observational cohort study including adult patients with sepsis. Clinical and laboratory data were collected at baseline (M1) and repeated 48 ± 6 h later (M2). The primary outcome was 28-day mortality. Candidate biomarkers included C-reactive protein (CRP), procalcitonin (PCT), lactate (LAC), and neutrophil-to-lymphocyte ratio (NLR). PCT clearance and NLR change were calculated as relative changes between M1 and M2, whereas 48 h CRP and 48 h lactate were evaluated as early reassessment values. Exploratory logistic regression models were constructed using admission SOFA as the clinical reference model. Model discrimination and fit were summarized using receiver operating characteristic analysis, likelihood-ratio testing, and Nagelkerke R²; the models were not intended as validated individual-level risk calculators. Results: The 48 h landmark analytical cohort included 126 patients, of whom 44 (34.9%) died within 28 days. Admission biomarker values showed limited prognostic signal. SOFA alone showed fair discrimination (AUC 0.740). Among the primary SOFA-augmented models, SOFA plus PCT clearance showed the highest discrimination and explanatory performance (AUC 0.810; Nagelkerke R² 0.332) and significantly improved model fit compared with SOFA alone. SOFA plus NLR change and SOFA plus 48 h lactate also provided incremental prognostic information, although their gains were more modest. In exploratory combined modeling, SOFA plus PCT clearance and NLR change provided the most coherent additional signal, with all predictors retaining independent associations with 28-day mortality. Conclusions: In this exploratory single-center 48 h landmark analysis, selected routine biomarker reassessment measures were associated with 28-day mortality beyond admission SOFA. PCT clearance provided the clearest incremental prognostic signal, while NLR change offered complementary information. Persistent 48 h lactate elevation was also informative, whereas lactate clearance was not. These findings should be interpreted as hypothesis-generating and require validation in larger cohorts, ideally including serial organ dysfunction measures such as 48 h SOFA or SOFA change. Full article

(This article belongs to the Special Issue Diagnosis and Prognosis of Sepsis)

► Show Figures

Figure 1

14 pages, 1590 KB

Open AccessArticle

Association of Triglyceride-to-HDL-C Ratio, Triglyceride–Glucose Index, and Inflammatory Biomarkers with Mortality in Intensive Care Unit Patients with Sepsis

by Nilgün Şahin, Semih Aydemir, Nazan Has Selmi, İbrahim Ertaş, Yavuz Kutay Gökçe, Cihan Döğer, Gökçen Terzi and Mesher Ensarioğlu

Diagnostics 2026, 16(6), 844; https://doi.org/10.3390/diagnostics16060844 - 12 Mar 2026

Viewed by 664

Abstract

Background/Objectives: This study aimed to investigate the prognostic significance of the triglyceride–glucose index (TGI), triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, and inflammatory biomarkers in predicting short-term mortality among intensive care unit (ICU) patients with sepsis. Additionally, this study evaluated whether combining these indices [...] Read more.

Background/Objectives: This study aimed to investigate the prognostic significance of the triglyceride–glucose index (TGI), triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, and inflammatory biomarkers in predicting short-term mortality among intensive care unit (ICU) patients with sepsis. Additionally, this study evaluated whether combining these indices with conventional clinical scores improves prognostic accuracy. Methods: This retrospective cohort study included 600 adult ICU patients diagnosed with sepsis according to Sepsis-3 criteria between January 2020 and April 2025. Clinical, biochemical, and hematological data were collected within the first 24 h of ICU admission. Metabolic indices (TGI, TG/HDL-C) and inflammatory markers (neutrophil-to-lymphocyte ratio [NLR], systemic immune-inflammation index [SII], and pan-immune-inflammation value [PIV]) were analyzed. The primary outcome was 28-day mortality. Receiver operating characteristic (ROC) analyses, Kaplan–Meier survival curves, and a multivariable logistic regression model were applied to determine prognostic performance. Results: Non-survivors exhibited significantly higher levels of TGI, TG/HDL-C, NLR, SII, and PIV compared to survivors (all p < 0.001). In ROC analysis, TGI (AUC = 0.75, 95% CI: 0.71–0.79), TG/HDL-C (AUC = 0.72, 95% CI: 0.68–0.76), and PIV (AUC = 0.78, 95% CI: 0.74–0.82) demonstrated good discriminative power for predicting 28-day mortality. Multivariate logistic regression identified TGI > 8.95 (OR = 1.44, 95% CI: 1.19–1.74, p < 0.001), TG/HDL-C > 3.95 (OR = 1.31, 95% CI: 1.08–1.59, p = 0.005), and PIV > 260 (OR = 1.49, 95% CI: 1.22–1.82, p < 0.001) as independent predictors of mortality. Integrating TGI and PIV with the SOFA score improved prognostic performance (ΔAUC = +0.04). Conclusions: Both TGI and TG/HDL-C are independent predictors of short-term mortality in septic ICU patients, reflecting the contribution of metabolic dysregulation to disease severity. The PIV demonstrated comparable predictive ability to conventional severity scores. Combining metabolic and inflammatory biomarkers with established clinical indices may enhance early risk stratification and guide personalized management strategies in sepsis. Full article

(This article belongs to the Special Issue Diagnosis and Prognosis of Sepsis)

► Show Figures

Figure 1

13 pages, 714 KB

Open AccessArticle

Free Thyroxine as a Predictor of Mortality in Critically Ill Septic Patients—A Retrospective Study

by Matei Florin Negruț, Vlad Pastor, Robert Bolcaș, Oana Antal, Robert Szabo and Cristina Petrișor

Diagnostics 2026, 16(5), 680; https://doi.org/10.3390/diagnostics16050680 - 26 Feb 2026

Cited by 1 | Viewed by 619

Abstract

Background/Objectives: Euthyroid sick syndrome (ESS), and particularly low T3, have been associated with increased mortality in septic patients, yet the prognostic value of free thyroxine (fT4) remains controversial. This study aims to evaluate the association between fT4 on ICU admission and mortality in [...] Read more.

Background/Objectives: Euthyroid sick syndrome (ESS), and particularly low T3, have been associated with increased mortality in septic patients, yet the prognostic value of free thyroxine (fT4) remains controversial. This study aims to evaluate the association between fT4 on ICU admission and mortality in septic patients. Methods: We conducted a single-center, retrospective observational study including 149 adult patients with sepsis or septic shock admitted to the Anesthesia and Intensive Care I Department of the Cluj County Emergency Hospital, Cluj-Napoca, Romania, between January 2019 and September 2025. Free T4 and thyroid-stimulating hormone (TSH) levels were measured within 24 h of ICU admission. The primary outcome was 28-day mortality, and the secondary outcome was in-hospital mortality. Demographic data, comorbidities, severity scores (SOFA, APACHE II), laboratory parameters, and outcomes were analyzed. Univariate and multivariate logistic regression analyses were performed, and predictive performance was assessed using area under the receiver operating characteristic curve (AUROC). Results: A total of 149 patients were included. Twenty-eight-day mortality was 29.73%, and 53.57% in patients with sepsis and septic shock, respectively. Serum fT4 was significantly lower in non-survivors, for both primary and secondary outcome (p = 0.01 and p = 0.014, respectively), whereas TSH levels were similar between groups. In the univariate analysis, fT4 showed moderate predictive ability for mortality (AUROC 0.615 and 0.632). Multivariate models, including age, hemoglobin, SOFA score, and fT4, showed a greater discriminative performance (AUROC 0.805 and 0.799). Conclusions: Lower fT4 levels on ICU admission seem to be independently associated with increased mortality in septic patients. Incorporating fT4 into multiparametric prognostic models might improve early risk stratification in sepsis, particularly in settings where other thyroid parameters are not routinely available. Full article

(This article belongs to the Special Issue Diagnosis and Prognosis of Sepsis)

► Show Figures

Figure 1

13 pages, 889 KB

Open AccessArticle

Evaluation of the Course of Acute-Phase Reactants in the Postoperative Period of Newborns and Their Diagnostic Utility in Identifying Postoperative Sepsis

by Erkan Deniz, Leyla Sero, Duygu Tuncel and Nilufer Okur

Diagnostics 2026, 16(4), 545; https://doi.org/10.3390/diagnostics16040545 - 12 Feb 2026

Viewed by 505

Abstract

Background/Objectives: Neonatal sepsis remains a major diagnostic challenge, particularly in postoperative infants where systemic inflammatory responses may mimic infection; therefore, reliable biomarkers are urgently needed to distinguish sepsis from normal post-surgical changes. Methods: This prospective cohort study included 135 neonates who [...] Read more.

Background/Objectives: Neonatal sepsis remains a major diagnostic challenge, particularly in postoperative infants where systemic inflammatory responses may mimic infection; therefore, reliable biomarkers are urgently needed to distinguish sepsis from normal post-surgical changes. Methods: This prospective cohort study included 135 neonates who underwent surgery without preoperative signs of infection. Serum levels of C-reactive protein (CRP) and procalcitonin (PCT) were measured preoperatively and at 24, 72 and 120 h postoperatively. Patients were classified as having proven sepsis based on positive blood cultures or clinical sepsis using European Medicines Agency (EMA) neonatal sepsis scoring. Biomarker levels were compared between septic and non-septic infants, and diagnostic performance was evaluated using receiver operating characteristic analysis. Results: Sixteen infants had proven sepsis and twenty-five had clinical sepsis. Both CRP and PCT levels showed a significant rise in septic infants at 72 h postoperatively (p < 0.01) and remained elevated at 120 h. PCT demonstrated the highest diagnostic accuracy at 72 h (AUC 0.911; threshold 1.2 µg/L; sensitivity 83%; specificity 84%), while CRP also showed good performance (AUC 0.802–0.838). Conclusions: CRP, PCT and albumin are valuable postoperative sepsis markers; however, single-parameter interpretation is insufficient, and a multiparametric, time-dependent approach provides superior diagnostic reliability in neonatal sepsis. Full article

(This article belongs to the Special Issue Diagnosis and Prognosis of Sepsis)

► Show Figures

Figure 1

12 pages, 3524 KB

Open AccessArticle

Is GDF15 a Feasible Biomarker in Sepsis?

by Ertugrul Yigit, Mehmet Akif Simsek, Merve Huner Yigit, Gorkem Akca, Berat Sonmez and Hakki Uzun

Diagnostics 2025, 15(17), 2224; https://doi.org/10.3390/diagnostics15172224 - 2 Sep 2025

Cited by 2 | Viewed by 1406

Abstract

Background/Objectives: Sepsis is a high-mortality syndrome characterized by organ dysfunction resulting from a dysregulated host response to infection. This study aimed to evaluate the potential of growth differentiation factor 15 (GDF15), a stress-inducible cytokine, as a biomarker in patients diagnosed with urosepsis. [...] Read more.

Background/Objectives: Sepsis is a high-mortality syndrome characterized by organ dysfunction resulting from a dysregulated host response to infection. This study aimed to evaluate the potential of growth differentiation factor 15 (GDF15), a stress-inducible cytokine, as a biomarker in patients diagnosed with urosepsis. Methods: A total of 13 patients diagnosed with urosepsis, based on an increase of ≥2 points in the Sequential Organ Failure Assessment (SOFA) score and positive urine culture, were included in the study. Daily blood samples were collected from patients for 10 days, and serum levels of GDF15, procalcitonin (PCT), and presepsin (P-SEP) were measured by ELISA. C-reactive protein (CRP), blood urea nitrogen (BUN), serum creatinine, estimated glomerular filtration rate (eGFR), hemoglobin, and neutrophil, lymphocyte, and platelet counts were determined using autoanalyzers. Temporal changes were analyzed using the Friedman test, and correlations were analyzed using Spearman’s test. Results: GDF15 levels began to decrease from Day 3, with a significant decline observed from Day 7 compared to Day 1 (p < 0.001). Similar decreasing trends were observed in CRP and PCT levels, whereas presepsin levels did not exhibit significant changes. Significant positive correlations were identified between GDF15 and CRP (r = 0.65, p = 0.015), BUN (r = 0.57, p = 0.041), and creatinine (r = 0.62, p = 0.024), and a significant negative correlation was observed with eGFR (r = −0.62, p = 0.024). No significant correlation was found between GDF15 and presepsin (p > 0.05). Conclusions: GDF15 is a biomarker sensitive to the resolution phase of inflammation and organ dysfunction in sepsis, demonstrating significant temporal changes. It holds potential as an indicator for monitoring clinical progression and assessing prognosis. Full article

(This article belongs to the Special Issue Diagnosis and Prognosis of Sepsis)

► Show Figures

Figure 1

14 pages, 1243 KB

Open AccessArticle

The Prognostic Value of the CALLY Index in Sepsis: A Composite Biomarker Reflecting Inflammation, Nutrition, and Immunity

by Ali Sarıdaş and Remzi Çetinkaya

Diagnostics 2025, 15(8), 1026; https://doi.org/10.3390/diagnostics15081026 - 17 Apr 2025

Cited by 29 | Viewed by 3178

Abstract

Background/Objectives: Sepsis remains a leading cause of mortality worldwide, necessitating the development of effective prognostic markers for early risk stratification. The C-reactive protein–albumin–lymphocyte (CALLY) index is a novel biomarker that integrates inflammatory, nutritional, and immunological parameters. This study aimed to evaluate the [...] Read more.

Background/Objectives: Sepsis remains a leading cause of mortality worldwide, necessitating the development of effective prognostic markers for early risk stratification. The C-reactive protein–albumin–lymphocyte (CALLY) index is a novel biomarker that integrates inflammatory, nutritional, and immunological parameters. This study aimed to evaluate the association between the CALLY index and 30-day all-cause mortality in sepsis patients. Methods: This retrospective cohort study included adult patients diagnosed with sepsis in the emergency department between 1 January 2022, and 1 January 2025. The CALLY index was calculated as (CRP × absolute lymphocyte count)/albumin. The primary outcome was 30-day all-cause mortality. Five machine learning models—extreme gradient boosting (XGBoost), multilayer perceptron, random forest, support vector machine, and generalized linear model—were developed for mortality prediction. Four feature selection strategies (gain score, SHAP values, Boruta, and LASSO regression) were used to evaluate predictor consistency. The clinical utility of the CALLY index was assessed using decision curve analysis (DCA). Results: A total of 1644 patients were included, of whom 345 (21.0%) died within 30 days. Among the five machine learning models, the XGBoost model achieved the highest performance (AUC: 0.995, R²: 0.867, MAE: 0.063, RMSE: 0.145). In gain-based feature selection, the CALLY index emerged as the top predictor (gain: 0.187), followed by serum lactate (0.185) and white blood cell count (0.117). The CALLY index also ranked second in SHAP analysis (mean value: 0.317) and first in Boruta importance (mean importance: 37.54). DCA showed the highest net clinical benefit of the CALLY index within the 0.10–0.15 risk threshold range. Conclusions: This study demonstrates that the CALLY index is a significant predictor of 30-day mortality in sepsis patients. Machine learning analysis further reinforced the prognostic value of the CALLY index. Full article

(This article belongs to the Special Issue Diagnosis and Prognosis of Sepsis)

► Show Figures

Figure 1

13 pages, 1372 KB

Open AccessArticle

The Association of Body Mass Index and Waist Circumference with Sepsis-Related Mortality in South Korea

by Tak-Kyu Oh and In-Ae Song

Diagnostics 2024, 14(6), 574; https://doi.org/10.3390/diagnostics14060574 - 7 Mar 2024

Cited by 5 | Viewed by 2301

Abstract

Obesity is a major public health problem worldwide and is associated with increased morbidity and mortality. However, studies have shown that obesity has sepsis-related mortality benefits. We aimed to determine whether there is an improved sepsis-related survival rate in patients with obesity in [...] Read more.

Obesity is a major public health problem worldwide and is associated with increased morbidity and mortality. However, studies have shown that obesity has sepsis-related mortality benefits. We aimed to determine whether there is an improved sepsis-related survival rate in patients with obesity in South Korea. We included data from 77,810 adults with sepsis between 1 January 2013 and 31 December 2020, extracted from the National Health Insurance Service database in South Korea. The patients underwent standard health examinations within a year before sepsis, and body mass index (BMI) and waist circumference (WC) were used to reflect obesity. Lower 30-day and 1-year mortality rates were observed in the overweight and obesity groups after adjusting for confounders, including WC. However, there was no difference in mortality between the patients with severe obesity and those with normal BMI. Underweight was associated with higher 30-day and 1-year mortality. Higher 30-day and 1-year mortality was found in the high and very high WC groups. In conclusion, patients with abdominal obesity and overweight and obesity and with sepsis showed reduced mortality, whereas underweight patients with sepsis showed increased mortality in South Korea. Full article

(This article belongs to the Special Issue Diagnosis and Prognosis of Sepsis)

► Show Figures

Figure 1

Review

Jump to: Research

16 pages, 1869 KB

Open AccessReview

Sepsis-Associated Acute Kidney Injury: What’s New Regarding Its Diagnostics and Therapeutics?

by Dimitris Kounatidis, Ilektra Tzivaki, Stavroula Daskalopoulou, Anna Daskou, Andreas Adamou, Anastasia Rigatou, Evangelos Sdogkos, Irene Karampela, Maria Dalamaga and Natalia G. Vallianou

Diagnostics 2024, 14(24), 2845; https://doi.org/10.3390/diagnostics14242845 - 17 Dec 2024

Cited by 22 | Viewed by 10148

Abstract

Sepsis-associated acute kidney injury (SA-AKI) is defined as the development of AKI in the context of a potentially life-threatening organ dysfunction attributed to an abnormal immune response to infection. SA-AKI has been associated with increased mortality when compared to sepsis or AKI alone. [...] Read more.

Sepsis-associated acute kidney injury (SA-AKI) is defined as the development of AKI in the context of a potentially life-threatening organ dysfunction attributed to an abnormal immune response to infection. SA-AKI has been associated with increased mortality when compared to sepsis or AKI alone. Therefore, its early recognition is of the utmost importance in terms of its morbidity and mortality rates. The aim of this review is to shed light on the pathophysiological pathways implicated in SA-AKI as well as its diagnostics and therapeutics. In this review, we will elucidate upon serum and urinary biomarkers, such as creatinine, cystatin, neutrophil gelatinase-associated lipocalin (NGAL), proenkephalin A 119–159, interleukin-6, interleukin-8 and interleukin-18, soluble toll-like receptor 2 (sTLR2), chemokine ligand 2 (CCL2) and chemokine C-C-motif 14 (CCL14). In addition, the role of RNA omics as well as machine learning programs for the timely diagnosis of SA-AKI will be further discussed. Moreover, regarding SA-AKI treatment, we will elaborate upon potential therapeutic agents that are being studied, based on the pathophysiology of SA-AKI, in humans and in animal models. Full article

(This article belongs to the Special Issue Diagnosis and Prognosis of Sepsis)

► Show Figures

Figure 1

18 pages, 679 KB

Open AccessReview

Advancing Pathogen Identification: The Role of Digital PCR in Enhancing Diagnostic Power in Different Settings

by Alessia Mirabile, Giuseppe Sangiorgio, Paolo Giuseppe Bonacci, Dalida Bivona, Emanuele Nicitra, Carmelo Bonomo, Dafne Bongiorno, Stefania Stefani and Nicolò Musso

Diagnostics 2024, 14(15), 1598; https://doi.org/10.3390/diagnostics14151598 - 25 Jul 2024

Cited by 52 | Viewed by 13934

Abstract

Digital polymerase chain reaction (dPCR) has emerged as a groundbreaking technology in molecular biology and diagnostics, offering exceptional precision and sensitivity in nucleic acid detection and quantification. This review highlights the core principles and transformative potential of dPCR, particularly in infectious disease diagnostics [...] Read more.

Digital polymerase chain reaction (dPCR) has emerged as a groundbreaking technology in molecular biology and diagnostics, offering exceptional precision and sensitivity in nucleic acid detection and quantification. This review highlights the core principles and transformative potential of dPCR, particularly in infectious disease diagnostics and environmental surveillance. Emphasizing its evolution from traditional PCR, dPCR provides accurate absolute quantification of target nucleic acids through advanced partitioning techniques. The review addresses the significant impact of dPCR in sepsis diagnosis and management, showcasing its superior sensitivity and specificity in early pathogen detection and identification of drug-resistant genes. Despite its advantages, challenges such as optimization of experimental conditions, standardization of data analysis workflows, and high costs are discussed. Furthermore, we compare various commercially available dPCR platforms, detailing their features and applications in clinical and research settings. Additionally, the review explores dPCR’s role in water microbiology, particularly in wastewater surveillance and monitoring of waterborne pathogens, underscoring its importance in public health protection. In conclusion, future prospects of dPCR, including methodological optimization, integration with innovative technologies, and expansion into new sectors like metagenomics, are explored. Full article

(This article belongs to the Special Issue Diagnosis and Prognosis of Sepsis)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Diagnosis and Prognosis of Sepsis

Share This Special Issue

Editor

Special Issue Information

Benefits of Publishing in a Special Issue

Published Papers (11 papers)

Research

Review

Further Information

Guidelines

MDPI Initiatives

Follow MDPI