Early diagnosis of severe infection

Sepsis is recognised as a global health concern and has a high morbidity and mortality. Evidence shows that mortality rates can be reduced by up to 50% through early recognition and treatment. However, indiscriminate antibiotic use can lead to resistant microbial strains, and increased cost. Sepsis is newly redefined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Screening tools exist and the UK National Institute for Health and Care Excellence (NICE) provide a recommended screening tool which identifies most children at risk from sepsis. Current biomarkers do not reliably differentiate between sepsis and inflammation, and show a delayed response (12-24 hours) to bacterial infection. Evolving research shows procalcitonin is a biomarker released in response to inflammatory stimuli during bacterial infections, with very high levels produced in sepsis and enables real-time monitoring. This review discusses the new definitions of sepsis, importance of making an early diagnosis with appropriate investigations and future diagnostic advancements.