September is the Sepsis awareness month and the 8th World Sepsis Day is held on 13th September 2019. The day is an initiative by the Global Sepsis Alliance (GSA), a registered non-profit charity organisation. It is the World Sepsis Day’s steering committee, a committee of both sepsis experts and survivors, that defines the direction of World Sepsis Day.
What is sepsis?
Sepsis is the leading cause of death among critically ill patients in intensive care units (ICU) with a continuously increasing incidence and a high mortality rate. Sepsis arises when the body’s response to an infection (bacterial, fungal or viral) starts to injure its own tissues and organs. This response might lead to septic shock with multi-organ failure, and death - especially if not recognised early and treated promptly. Early treatment improves outcome suggesting that rapid identification of patients with sepsis is important [1, 2].
SEPSIS - EXPLAINED IN 3 MINUTES
The following video from World Sepsis Day explains sepsis in 3 minutes - including the most common causes, symptoms, how it can be diagnosed and treated, and more.
have been suggested to facilitate early diagnosis of severe bacterial infections [3, 4, 5, 6]. Still, the performance of WBC, CRP and PCT has been questioned regarding differentiating sepsis from non-infectious inflammatory response [7,8,9].
The novel biomarker Calprotectin is released from neutrophil granulocytes in response to inflammation and/or infection. The early release of calprotectin upon inflammation and/or infection, in combination with rapid turnaround-time for analysis, suggests that calprotectin is a useful biomarker for diagnosis of severe infections and sepsis .
Calprotectin – promising biomarker for diagnosis of sepsis
The workshop was hosted by Gentian, and Dr. Jordi Rello, MD, PhD (Spain) and Dr. Toralph Ruge, MD, PhD (Sweden) were invited to present their work and research in relation to calprotectin and other biomarkers’ role in diagnosis of severe infections and sepsis. Their presentations showed studies and results supporting the ability of calprotectin to discriminate patients with acute infections from patients with other states of inflammatory responses:
Calprotectin: independent predictor of 28-day mortality in septic patients 
Calprotectin: promising biomarker in early diagnosis, risk stratification, and evaluation of prognosis in septic patients 
Calprotectin: accurate marker of sepsis in very low birth weight newborns 
Calprotectin: significant diagnostic accuracy for the bacterial etiology of sepsis 
Ongoing studies: calprotectin as a sepsis marker
Early diagnosis of infections and sepsis is essential to minimize the time from onset of symptoms until initiation of proper medical therapy, which subsequently can reduce risk of protracted infections, complications and mortality. Another reason is to avoid improper use of antibiotics in cases where there is no underlying bacterial infection, emphasized by an increasing problem with antibiotic resistance and bacterial infections becoming a major threat to our health.
Biomarkers, which at an early stage of infection can distinguish between bacterial and viral infections, could lead to a more selective use of antibiotics. Some published studies support a role for calprotectin in this setting [3, 12].
Clinical studies are currently ongoing with aim to further investigate performance of calprotectin in differentiation between bacterial and viral infections as well as in differentiation between severe infections/sepsis and other diagnoses in patients at emergency departments and Intensive care units.
Jonsson N, Nilsen T, Gille-Johnson P, Bell M, Martling CR, Larsson A, et al. Calprotectin as an early biomarker of bacterial infections in critically ill patients: an exploratory cohort assessment. Crit Care Resusc 2017;19(3):205-13.
Aguiar FJB, Ferreira-Junior M, Sales MM, et.al. [C-reactive protein: clinical applications and proposals for a rational use] [Portuguese]. Rev Assoc Med Bras 2013; 59: 85-92.
Vincent, JL, Beumier M. Diagnostic and prognostic markers in sepsis. Expert Rev Anti Infect Ther 2013; 11: 265-75
Reinhart K, Bauer M, Riedemann NC, Hartog CS. New Approaches to Sepsis: Molecular Diagnostics and Biomarkers. Clin Microbiol Rev 2012; 25: 609-34
Clyne B, Olshaker JS. The C-reactive protein. J Emerg Med 1999; 17 : 1019-25
Ugarte H, Silva E, Mercan D, et al. Procalcitonin used as a marker of infection int the intensive care unit. Crit Care Med 1999; 498-504.
Coburn B, Morris AM, Tomlinson G, Detsky AS. Does this adult patient with suspected bacteremia require blood culture? JAMA 2012; 308: 502-11