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Sepsis: Current Updates and Perspectives
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Sepsis: Current Updates and Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Intensive Care".

Deadline for manuscript submissions: 15 August 2025 | Viewed by 1565

Special Issue Editor

Dr. Ecaterina Scarlatescu

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Guest Editor
Anesthesia and Intensive Care Department, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
Interests: critical care medicine; disseminated intravascular coagulation; hemostasis; blood purification therapies; liver failure

Special Issue Information

Dear Colleagues,

Despite the remarkable progress and technical developments in intensive care medicine, sepsis remains a major global health challenge with a high mortality rate. Nowadays, the rise of antibiotic resistance mandates a more judicious approach to antibiotics; therefore, antimicrobial stewardship is crucial. Rapid diagnostic tools for pathogen identification are being integrated into care, enabling timely de-escalation of broad-spectrum antibiotics and helping prevent resistance.

Recent advancements in sepsis management emphasize early detection, timely intervention, and personalized treatment for patients with sepsis. It became evident that "one size does not fit all" in sepsis. Early diagnosis and outcome prediction with novel biomarkers and AI are transforming sepsis management and aiding in decision-making. AI and machine learning are valuable tools for identifying sepsis patients' unique immune response profiles and for the future development of targeted therapies that can more precisely modulate immune responses. The future perspectives hold promises for developing even more personalized treatment options by integrating complex data from genomics, proteomics, and metabolomics.

In this Special Issue, we invite researchers and clinicians to submit their work, which may include original clinical research studies, as well as narrative and systematic reviews. We seek contributions that provide additional insights into recent advancements in understanding sepsis pathophysiology, innovations in diagnostics, and personalized medicine for patients with sepsis. We also welcome perspectives on future strategies for the diagnosis and treatment of sepsis, aiming to improve patient outcomes.

Dr. Ecaterina Scarlatescu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sepsis biomarkers
  • diagnostic tools
  • cytokines
  • inflammation
  • infection
  • antibiotherapy
  • blood purification
  • novel therapies

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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14 pages, 1491 KiB  
Article
Evaluation of Presepsin for Early Diagnosis of Sepsis in the Emergency Department
by Andrea Piccioni, Silvia Baroni, Gloria Rozzi, Fabio Belvederi, Simone Leggeri, Fabio Spagnuolo, Michela Novelli, Giulia Pignataro, Marcello Candelli, Marcello Covino, Antonio Gasbarrini and Francesco Franceschi
J. Clin. Med. 2025, 14(7), 2480; https://doi.org/10.3390/jcm14072480 - 4 Apr 2025
Viewed by 405
Abstract
Background: to date, there are no specific markers available for diagnosing sepsis. Diagnosis is, indeed, mainly determined by clinical suspicion and the evaluation of the patient’s overall condition. This evaluation involves assessing various inflammatory markers, such as C-reactive protein (CRP) and procalcitonin [...] Read more.
Background: to date, there are no specific markers available for diagnosing sepsis. Diagnosis is, indeed, mainly determined by clinical suspicion and the evaluation of the patient’s overall condition. This evaluation involves assessing various inflammatory markers, such as C-reactive protein (CRP) and procalcitonin (PCT), along with markers of tissue hypoxia, such as serum lactate. Additionally, it includes scores that account for complete blood count (CBC), organ function markers, and the patient’s vital parameters, including SOFA, qSOFA, SIRS, and NEWS. Over the years, various potential biomarkers have been studied; among these presepsin appears to offer some significant advantages. Objective: Presepsin, which is the N-terminal fragment of the soluble component of CD14, is primarily elevated in infectious conditions. Its levels rise much earlier in the context of infection compared to currently used biomarkers. As a result, Presepsin shows promise for the early identification of septic patients and could aid in prognostic assessment, allowing clinicians to prioritize care for critically ill individuals. Methods: this study aims to evaluate the role of serum presepsin in the early diagnosis of sepsis in patients who present to the emergency room with a clinical suspicion of sepsis. The secondary objectives include comparing the diagnostic performance of presepsin with traditional biomarkers currently used for sepsis diagnosis and assessing its utility as a prognostic biomarker for mortality risk stratification, in comparison with validated severity prediction scores. Result: Presepsin had valuable diagnostic utility for sepsis (AUC 0.946, p < 0.001) comparable to PCT (AUC 0.905, p < 0.001). Conclusions: the combination of Presepsin, PCT, and EWS yielded the highest diagnostic accuracy for sepsis. Full article
(This article belongs to the Special Issue Sepsis: Current Updates and Perspectives)
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14 pages, 2291 KiB  
Systematic Review
Hemoadsorption in the Management of Septic Shock: A Systematic Review and Meta-Analysis
by David Steindl, Tim Schroeder, Alexander Krannich and Jens Nee
J. Clin. Med. 2025, 14(7), 2285; https://doi.org/10.3390/jcm14072285 - 27 Mar 2025
Viewed by 890
Abstract
Background/Objectives: Septic shock remains a significant clinical challenge with consistently high mortality rates. Recent investigations have focused on the efficacy of CytoSorb® (CytoSorbents Corporation, Monmouth Junction, NJ, USA), an extracorporeal cytokine adsorber, and how it impacts outcomes in sepsis. The current [...] Read more.
Background/Objectives: Septic shock remains a significant clinical challenge with consistently high mortality rates. Recent investigations have focused on the efficacy of CytoSorb® (CytoSorbents Corporation, Monmouth Junction, NJ, USA), an extracorporeal cytokine adsorber, and how it impacts outcomes in sepsis. The current meta-analysis reports on the impact of CytoSorb® on survival, specifically in septic shock patients. Methods: We conducted a comprehensive systematic search across the PubMed and COCHRANE databases for studies published up to 10 June 2024. The analysis prioritized randomized controlled trials and observational studies with control groups involving septic shock patients while excluding case reports and case series. Nine studies were finally included in our meta-analysis following the initial screening of 115 articles after excluding duplicates and irrelevant entries. Results: The meta-analysis was performed on 744 critically ill patients with septic shock from one RCT and eight observational studies. Of these, 449 patients received treatment with CytoSorb® in addition to standard care. Our data indicate that CytoSorb® use is associated with reduced in-hospital mortality, evidenced by an odds ratio (OR) of 0.64 [0.42; 0.97] and a p-value of 0.036. For 28–30-day mortality, the findings were more pronounced with an OR of 0.46 [0.28; 0.78] and a p-value of 0.003. The analysis of the longest observed mortality showed a trend for improved survival within the CytoSorb group; however, it did not reach statistical significance. Additionally, there was a significant improvement in hemodynamic stability as a secondary endpoint, as evidenced by notable reductions in vasopressor requirements in the hemoadsorption group. Conclusions: The current meta-analysis suggests that the use of CytoSorb® alongside standard of care management may be linked to improved short-term survival in patients with septic shock; however, these findings should be interpreted with caution in light of the heterogeneity and the modest quality of the studies included. Prospective studies are needed to better determine the impact of hemoadsorption on shock reversal and survival in these critically ill patients. Full article
(This article belongs to the Special Issue Sepsis: Current Updates and Perspectives)
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