Diagnosis of sepsis: which clinical and laboratory biomarkers are useful?

The quest for an unequivocal diagnostic tool for sepsis has persisted for decades, but this goal remains elusive. The diagnosis of sepsis is characterized by its complexity, which encompasses dozens of biochemical, hematologic, and immunologic parameters as well as complex microbiological diagnostics. During the last decade, the integration of omics technologies has further complicated this landscape. Despite these advancements, clinical diagnosis remains the gold standard for the diagnosis of sepsis. In the following review, we provide an overview of select diagnostic biomarkers that are deemed readily applicable in routine clinical practice, thus extending beyond the confines of university hospitals. Verification of the reliability and usefulness of a diagnostic parameter generally takes several years, and this process is more difficult in patients with sepsis compared with other patients because of the complexity of this clinical condition. Nevertheless, the introduction of new technologies, the intensive use of bedside diagnostics, and the contribution of omics technologies are moving us toward the realization of personalized medicine and theranostics.