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Evaluation of a Reliable Biomarker in a Cecal Ligation and Puncture-Induced Mouse Model of Sepsis
Published on: December 9, 2022
Markers for sepsis diagnosis in the forensic setting: state of the art
Cristian Palmiere1, Marc Augsburger
1Cristian Palmiere, cristian.palmiere@chuv.ch, University Center of Legal Medicine, Lausanne, Switzerland.
Abstract:
Reliable diagnoses of sepsis remain challenging in forensic pathology routine despite improved methods of sample collection and extensive biochemical and immunohistochemical investigations. Macroscopic findings may be elusive and have an infectious or non-infectious origin. Blood culture results can be difficult to interpret due to postmortem contamination or bacterial translocation. Lastly, peripheral and cardiac blood may be unavailable during autopsy. Procalcitonin, C-reactive protein, and interleukin-6 can be measured in biological fluids collected during autopsy and may be used as in clinical practice for diagnostic purposes. However, concentrations of these parameters may be increased due to etiologies other than bacterial infections, indicating that a combination of biomarkers could more effectively discriminate non-infectious from infectious inflammations. In this article, we propose a review of the literature pertaining to the diagnostic performance of classical and novel biomarkers of inflammation and bacterial infection in the forensic setting.
Insights
Diagnosing sepsis in forensic pathology is difficult due to elusive macroscopic signs and unreliable blood cultures. Biomarker combinations may improve distinguishing infectious from non-infectious inflammation.
Area of Science:
- Forensic Pathology
- Clinical Pathology
- Biomarker Research
Background:
- Sepsis diagnosis in forensic pathology is challenging, with limitations in macroscopic findings and blood culture interpretation.
- Postmortem changes like contamination and bacterial translocation complicate traditional diagnostic methods.
- Availability of peripheral and cardiac blood during autopsy can be limited.
Purpose of the Study:
- To review the diagnostic performance of inflammation and infection biomarkers in forensic settings.
- To evaluate classical and novel biomarkers for sepsis diagnosis in forensic casework.
- To identify strategies for differentiating infectious from non-infectious causes of inflammation postmortem.
Main Methods:
- Literature review of studies on biomarker utility in forensic sepsis diagnosis.
- Analysis of diagnostic performance data for various inflammatory markers.
- Assessment of biomarker combinations for improved discrimination.
Main Results:
- Procalcitonin, C-reactive protein, and interleukin-6 show potential but can be elevated in non-infectious conditions.
- A combination of biomarkers may offer better discrimination between infectious and non-infectious inflammation.
- Further research is needed to validate novel biomarkers in the forensic context.
Conclusions:
- Current diagnostic methods for sepsis in forensic pathology have significant limitations.
- Biomarker panels hold promise for improving the accuracy of postmortem sepsis diagnosis.
- Future studies should focus on validating combined biomarker approaches for forensic applications.
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