Recent Advances in Sepsis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Laboratory Medicine".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 417

Special Issue Editor


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Guest Editor
1. Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
2. University Clinical Hospital Center "Bezanijska Kosa", Belgrade, Serbia
Interests: antibiotics; ischemia-reperfusion injury; lipidomics; pharmacovigilance; bioethics
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Special Issue Information

Dear Colleagues,

Sepsis remains a leading cause of morbidity and mortality worldwide, posing significant challenges to healthcare systems. Despite advances in understanding its pathophysiology and management, sepsis continues to demand innovative diagnostic, therapeutic, and preventive strategies. This Special Issue, "Recent Advances in Sepsis", brings together cutting-edge research and reviews that highlight progress in sepsis care, from molecular mechanisms to clinical interventions. Topics include novel biomarkers, immune modulation, precision medicine approaches, and emerging therapies that aim to improve patient outcomes. Additionally, we explore advancements in sepsis surveillance, antimicrobial stewardship, and supportive care. By compiling multidisciplinary perspectives, this issue aims to foster collaboration among researchers and clinicians, ultimately contributing to the global fight against sepsis. We invite readers to explore these findings and join the ongoing effort to redefine sepsis management in the modern era.

Prof. Dr. Zoran Todorovic
Guest Editor

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Keywords

  • sepsis
  • biomarkers
  • diagnosis
  • personalized medicine

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Published Papers (2 papers)

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Review

23 pages, 481 KiB  
Review
Bug Wars: Artificial Intelligence Strikes Back in Sepsis Management
by Georgios I. Barkas, Ilias E. Dimeas and Ourania S. Kotsiou
Diagnostics 2025, 15(15), 1890; https://doi.org/10.3390/diagnostics15151890 - 28 Jul 2025
Abstract
Sepsis remains a leading global cause of mortality, with delayed recognition and empirical antibiotic overuse fueling poor outcomes and rising antimicrobial resistance. This systematic scoping review evaluates the current landscape of artificial intelligence (AI) and machine learning (ML) applications in sepsis care, focusing [...] Read more.
Sepsis remains a leading global cause of mortality, with delayed recognition and empirical antibiotic overuse fueling poor outcomes and rising antimicrobial resistance. This systematic scoping review evaluates the current landscape of artificial intelligence (AI) and machine learning (ML) applications in sepsis care, focusing on early detection, personalized antibiotic management, and resistance forecasting. Literature from 2019 to 2025 was systematically reviewed following PRISMA-ScR guidelines. A total of 129 full-text articles were analyzed, with study quality assessed via the JBI and QUADAS-2 tools. AI-based models demonstrated robust predictive performance for early sepsis detection (AUROC 0.68–0.99), antibiotic stewardship, and resistance prediction. Notable tools, such as InSight and KI.SEP, leveraged multimodal clinical and biomarker data to provide actionable, real-time support and facilitate timely interventions. AI-driven platforms showed potential to reduce inappropriate antibiotic use and nephrotoxicity while optimizing outcomes. However, most models are limited by single-center data, variable interpretability, and insufficient real-world validation. Key challenges remain regarding data integration, algorithmic bias, and ethical implementation. Future research should prioritize multicenter validation, seamless integration with clinical workflows, and robust ethical frameworks to ensure safe, equitable, and effective adoption. AI and ML hold significant promise to transform sepsis management, but their clinical impact depends on transparent, validated, and user-centered deployment. Full article
(This article belongs to the Special Issue Recent Advances in Sepsis)
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12 pages, 541 KiB  
Review
Presepsin in Hepatic Pathology: Bridging the Gap in Early Sepsis Detection
by Dana-Maria Bilous, Mihai Ciocîrlan, Cătălina Vlăduț and Carmen-Georgeta Fierbințeanu-Braticevici
Diagnostics 2025, 15(15), 1871; https://doi.org/10.3390/diagnostics15151871 - 25 Jul 2025
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Abstract
Sepsis represents a major cause of mortality, especially among patients with liver cirrhosis, who are at increased risk due to immune dysfunction, gut-derived bacterial translocation, and altered hepatic metabolism. Traditional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) often have [...] Read more.
Sepsis represents a major cause of mortality, especially among patients with liver cirrhosis, who are at increased risk due to immune dysfunction, gut-derived bacterial translocation, and altered hepatic metabolism. Traditional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) often have reduced diagnostic reliability in this subgroup, due to impaired liver and renal function. Presepsin, a soluble fragment of CD14 released during phagocytic activation, has emerged as a promising biomarker for early sepsis detection. This systematic review explores the diagnostic and prognostic utility of presepsin in cirrhotic and non-cirrhotic patients with suspected infection. Data from multiple clinical studies indicate that presepsin levels correlate with infection severity and clinical scores such as SOFA and APACHE II. In cirrhotic patients, presepsin demonstrates superior sensitivity and specificity compared to conventional biomarkers, maintaining diagnostic value despite hepatic dysfunction. Its utility extends to differentiating bacterial infections from fungal infections and monitoring treatment response. While preliminary evidence is compelling, further prospective, multicenter studies are required to validate its integration into standard care algorithms. Presepsin may become a valuable addition to clinical decision-making tools, particularly in hepatology-focused sepsis management. Full article
(This article belongs to the Special Issue Recent Advances in Sepsis)
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