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Biomarkers in pediatric sepsis: a review of recent literature
Mariza Z Oikonomakou1, Despoina Gkentzi2, Charalambos Gogos3
1Department of Pediatrics, Children's General Hospital of Patras, Greece.
Insights
Diagnosing pediatric sepsis is challenging as no single biomarker is perfect. Current biomarkers like C-reactive protein and procalcitonin are useful, but new multi-biomarker approaches may personalize treatment.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Biomarker research
Background:
- Sepsis is a major global cause of infant and child mortality.
- Early diagnosis and monitoring are crucial for effective sepsis management.
- No single biomarker reliably diagnoses sepsis, predicts severity, or monitors treatment response in children.
Purpose of the Study:
- To review the evidence for sepsis biomarkers in the pediatric population.
- To evaluate the diagnostic and prognostic utility of existing and emerging biomarkers.
- To explore future directions for personalized sepsis management.
Main Methods:
- Systematic review of existing literature on pediatric sepsis biomarkers.
- Analysis of commonly used biomarkers such as C-reactive protein and procalcitonin.
- Identification and assessment of novel biomarkers related to endothelial damage, inflammation, and cellular stress.
Main Results:
- C-reactive protein and procalcitonin are the most studied pediatric sepsis biomarkers.
- Numerous other biomarkers (endothelial, inflammatory, oxidative stress) show potential but have controversial utility.
- Biomarker performance can depend on infection site and pathogen.
Conclusions:
- Current sepsis biomarkers in children have limitations.
- A combination of biomarkers, potentially integrated with genomic data, may offer a personalized diagnostic and management strategy.
- Further research is needed to validate multi-biomarker models for pediatric sepsis.
Abstract:
Sepsis remains the leading cause of death in infants and children worldwide. Prompt diagnosis and monitoring of infection is pivotal to guide therapy and optimize outcomes. No single biomarker has so far been identified to accurately diagnose sepsis, monitor response and predict severity. We aimed to assess existing evidence of available sepsis biomarkers, and their utility in pediatric population. C-reactive protein and procalcitonin remain the most extensively evaluated and used biomarkers. However, biomarkers related to endothelial damage, vasodilation, oxidative stress, cytokines/chemokines and cell bioproducts have also been identified, often with regard to the site of infection and etiologic pathogen; still, with controversial utility. A multi-biomarker model driven by genomic tools could establish a personalized approach in future disease management.
