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Updated: Jul 5, 2025
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Role of diagnostic tests for sepsis in children: a review
Oenone Rodgers1, Clare Mills2, Chris Watson2
1Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK orodgers04@qub.ac.uk.
Insights
Pediatric sepsis diagnosis needs better tools. Novel biomarkers, used in panels, show promise for improving early sepsis detection and management in children, moving beyond current limited options like C-reactive protein.
Area of Science:
- Pediatric critical care medicine
- Clinical diagnostics
- Biomarker research
Background:
- Pediatric sepsis presents a global health challenge with varied clinical signs.
- Current diagnostic biomarkers, such as C-reactive protein and procalcitonin, have limitations in guiding rapid and appropriate treatment.
- The complexity of sepsis necessitates a move beyond single biomarker approaches.
Purpose of the Study:
- To review novel biomarkers and innovative uses of existing biomarkers for pediatric sepsis assessment and management.
- To highlight the challenges in current biomarker discovery and validation.
- To emphasize the need for platform studies to enhance biomarker efficiency in clinical practice.
Main Methods:
- Literature review focusing on novel host biomarkers for sepsis.
- Analysis of current diagnostic limitations and potential improvements.
- Discussion of methodological challenges in biomarker validation.
Main Results:
- Single biomarker discovery has not surpassed existing markers due to the complex nature of sepsis.
- Multi-analyte biomarker panels hold potential for improved diagnostic performance in recognizing sepsis complexity.
- Methodological heterogeneity in validation studies currently limits biomarker utility.
Conclusions:
- Developing panels of multiple host biomarkers is crucial for accurately diagnosing and managing pediatric sepsis.
- Standardized validation methodologies and platform studies are essential for clinical implementation.
- Improved diagnostics are fundamental to optimizing the clinical pathway for pediatric sepsis.
Abstract:
Paediatric sepsis has a significant global impact and highly heterogeneous clinical presentation. The clinical pathway encompasses recognition, escalation and de-escalation. In each aspect, diagnostics have a fundamental influence over outcomes in children. Biomarkers can aid in creating a larger low-risk group of children from those in the clinical grey area who would otherwise receive antibiotics 'just in case'. Current biomarkers include C reactive protein and procalcitonin, which are limited in their clinical use to guide appropriate and rapid treatment. Biomarker discovery has focused on single biomarkers, which, so far, have not outperformed current biomarkers, as they fail to recognise the complexity of sepsis. The identification of multiple host biomarkers that may form a panel in a clinical test has the potential to recognise the complexity of sepsis and provide improved diagnostic performance. In this review, we discuss novel biomarkers and novel ways of using existing biomarkers in the assessment and management of sepsis along with the significant challenges in biomarker discovery at present. Validation of biomarkers is made less meaningful due to methodological heterogeneity, including variations in sepsis diagnosis, biomarker cut-off values and patient populations. Therefore, the utilisation of platform studies is necessary to improve the efficiency of biomarkers in clinical practice.
