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New Diagnostic and Therapeutic Trends in Sepsis and Septic Shock
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New Diagnostic and Therapeutic Trends in Sepsis and Septic Shock

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

Deadline for manuscript submissions: 31 August 2025 | Viewed by 6637

Special Issue Editors

Dr. Christian Zanza

E-Mail Website
Guest Editor
Post Graduate School of Geriatric Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
Interests: critical care medicine; intensive care medicine; sepsis; ICU; hemodynamics; anesthesiology; intubation; resuscitation; airway management; mechanical ventilation
Special Issues, Collections and Topics in MDPI journals
Dr. Luigi La Via

E-Mail Website
Guest Editor
Department of Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Policlinico “G.Rodolico-San Marco”, 95123 Catania, Italy
Interests: loco-regional anesthesia; pain medicine; ERAS
Special Issues, Collections and Topics in MDPI journals
Dr. Antonio Voza

E-Mail Website
Guest Editor
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy
Interests: COVID-19; NIV; antibiotic treatment; pneumonia; sepsis shock
Special Issues, Collections and Topics in MDPI journals
Dr. Yaroslava Longhitano

E-Mail Website
Guest Editor
Department of Emergency Medicine—Emergency Medicine Residency Program, Humanitas University—Research Hospital, 20089 Rozzano, Italy
Interests: anesthesia; critical care; internal medicine; emergency medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The forthcoming Special Issue of the Journal of Clinical Medicine, titled “New Diagnostic and Therapeutic Trends in Sepsis and Septic Shock”, delves into the latest advancements and innovations aimed at improving the detection and treatment of these critical conditions. This Special Issue assembles a collection of cutting-edge research articles, reviews, and expert perspectives that illuminate recent progress in the field.

This Special Issue will focus on the following topics:

  1. Pathophysiological breakthroughs:
  • In-depth analyses of the molecular and cellular mechanisms driving sepsis and septic shock.
  • Insights into the dysregulated immune response and systemic inflammation characteristic of these conditions.
  1. Advancements in diagnostics:
  • Exploration of new biomarkers and their potential for early and accurate sepsis diagnosis.
  • The role of advanced imaging techniques and machine learning algorithms in enhancing diagnostic capabilities.
  1. Innovative therapeutic strategies:
  • The development and assessment of novel pharmacological agents targeting specific sepsis pathways.
  • Personalized medicine approaches tailored to individual patient profiles and responses.
  • Evaluation of emerging antimicrobial therapies and their integration into clinical practice.
  1. Optimizing critical care:
  • Updates on best practices for supportive care, including fluid management, vasopressors, and mechanical ventilation.
  • The application of extracorporeal life support systems and their effectiveness in severe sepsis cases.
  1. Clinical trials and implementation:
  • Summaries of recent pivotal clinical trials that have shaped current treatment protocols.
  • Discussions on the translation of research findings into routine clinical practice and guidelines.
  1. Future directions:
  • Exploration of potential future research avenues and the next generation of diagnostic and therapeutic tools.
  • Emphasis on the importance of multidisciplinary collaboration and global efforts to combat sepsis.

This Special Issue aims to serve as a comprehensive resource for clinicians, researchers, and healthcare professionals committed to advancing the understanding and management of sepsis and septic shock. By presenting the latest scientific discoveries and clinical innovations, the Journal of Clinical Medicine seeks to foster improved patient outcomes and drive forward the field of sepsis care.

Dr. Christian Zanza
Dr. Luigi La Via
Dr. Antonio Voza
Dr. Yaroslava Longhitano
Guest Editors

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
  • septic shock
  • diagnostics
  • therapeutics
  • biomarkers
  • critical care

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

Published Papers (3 papers)

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Research

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12 pages, 880 KiB  
Article
Biomarkers as Predictors of Mortality in Sepsis and Septic Shock for Patients Admitted to Emergency Department: Who Is the Winner? A Prospective Study
by Sonia Luka, Adela Golea, Raluca Mihaela Tat, Eugenia Maria Lupan Mureșan, George Teo Voicescu, Ștefan Cristian Vesa and Daniela Ionescu
J. Clin. Med. 2024, 13(19), 5678; https://doi.org/10.3390/jcm13195678 - 24 Sep 2024
Cited by 3 | Viewed by 2334
Abstract
Background/Objectives: Sepsis and septic shock remain significant contributors to high early mortality rates among patients admitted to the emergency department (ED). The objective of this study was to identify among newer biomarkers those with the highest sensitivity in early mortality prediction. Methods [...] Read more.
Background/Objectives: Sepsis and septic shock remain significant contributors to high early mortality rates among patients admitted to the emergency department (ED). The objective of this study was to identify among newer biomarkers those with the highest sensitivity in early mortality prediction. Methods: This prospective, unicentric, observational study enrolled 47 adult patients admitted to the ED between November 2020 and December 2022. This study monitored the kinetics of the older and newer biomarkers, including azurocidin (AZU1), soluble triggering receptor expressed on myeloid cells (sTREM), soluble urokinase-type plasminogen activator receptor (suPAR), high-sensitivity C-reactive protein (hsCRP), procalcitonin (PCT), and interleukin-6 (IL-6), and their capacity in predicting mortality. Results: SuPAR showed the most significant predictive utility for early prognosis of mortality in the ED, with an area under the curve (AUC) of 0.813 (95% CI: 0.672 to 0.912), a cutoff value > 8168 ng/mL, sensitivity of 75%, and specificity of 81.48% (p < 0.001). IL-6 and PCT showed comparable prognostic accuracy, whereas hsCRP and AZU1 demonstrated lower predictive performance. Conclusions: In our study, suPAR, IL-6, and PCT showed good predictive value for short-term mortality in sepsis and septic shock patients. Full article
(This article belongs to the Special Issue New Diagnostic and Therapeutic Trends in Sepsis and Septic Shock)
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Review

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12 pages, 1265 KiB  
Review
Anaphylaxis with Elevated Procalcitonin Mimicking Sepsis: A Literature Review and Report of Two Cases
by András Bánvölgyi, Kende Lőrincz, Mehdi Boostani, Efrat Bar-Ilan, Bernadett Hidvégi, Márta Medvecz, Norbert Kiss and Norbert M. Wikonkál
J. Clin. Med. 2025, 14(3), 785; https://doi.org/10.3390/jcm14030785 - 25 Jan 2025
Cited by 1 | Viewed by 1023
Abstract
Objectives: This review examines the role of serum procalcitonin (PCT) as a diagnostic marker for sepsis and its potential implications in anaphylaxis. Elevated PCT levels, often associated with bacterial infections, can complicate diagnosis when seen in anaphylaxis, especially when clinical features overlap [...] Read more.
Objectives: This review examines the role of serum procalcitonin (PCT) as a diagnostic marker for sepsis and its potential implications in anaphylaxis. Elevated PCT levels, often associated with bacterial infections, can complicate diagnosis when seen in anaphylaxis, especially when clinical features overlap with sepsis. Methods: We conducted a literature review on PCT in anaphylaxis to highlight key patterns and present two cases of anaphylactic shock initially misdiagnosed as sepsis due to elevated PCT levels. Results: The review supports that elevated PCT can occur in anaphylaxis, stressing the need for thorough patient history and symptom evaluation. In both cases, elevated PCT led to initial sepsis diagnoses, but further investigation identified anaphylaxis triggered by sulfamethoxazole/trimethoprim (SMX/TMP). Conclusions: These findings emphasize the need for considering anaphylaxis in differential diagnoses when elevated PCT levels are observed. Increased awareness of PCT’s potential association with allergic drug reactions is essential to ensure timely recognition, avoid diagnostic delays, and improve patient outcomes. Full article
(This article belongs to the Special Issue New Diagnostic and Therapeutic Trends in Sepsis and Septic Shock)
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28 pages, 2212 KiB  
Review
The Gut Microbiome in Sepsis: From Dysbiosis to Personalized Therapy
by Andrea Piccioni, Fabio Spagnuolo, Marcello Candelli, Antonio Voza, Marcello Covino, Antonio Gasbarrini and Francesco Franceschi
J. Clin. Med. 2024, 13(20), 6082; https://doi.org/10.3390/jcm13206082 - 12 Oct 2024
Cited by 2 | Viewed by 2788
Abstract
Sepsis is a complex clinical syndrome characterized by an uncontrolled inflammatory response to an infection that may result in septic shock and death. Recent research has revealed a crucial link between sepsis and alterations in the gut microbiota, showing that the microbiome could [...] Read more.
Sepsis is a complex clinical syndrome characterized by an uncontrolled inflammatory response to an infection that may result in septic shock and death. Recent research has revealed a crucial link between sepsis and alterations in the gut microbiota, showing that the microbiome could serve an essential function in its pathogenesis and prognosis. In sepsis, the gut microbiota undergoes significant dysbiosis, transitioning from a beneficial commensal flora to a predominance of pathobionts. This transformation can lead to a dysfunction of the intestinal barrier, compromising the host’s immune response, which contributes to the severity of the disease. The gut microbiota is an intricate system of protozoa, fungi, bacteria, and viruses that are essential for maintaining immunity and metabolic balance. In sepsis, there is a reduction in microbial heterogeneity and a predominance of pathogenic bacteria, such as proteobacteria, which can exacerbate inflammation and negatively influence clinical outcomes. Microbial compounds, such as short-chain fatty acids (SCFAs), perform a crucial task in modulating the inflammatory response and maintaining intestinal barrier function. However, the role of other microbiota components, such as viruses and fungi, in sepsis remains unclear. Innovative therapeutic strategies aim to modulate the gut microbiota to improve the management of sepsis. These include selective digestive decontamination (SDD), probiotics, prebiotics, synbiotics, postbiotics, and fecal microbiota transplantation (FMT), all of which have shown potential, although variable, results. The future of sepsis management could benefit greatly from personalized treatment based on the microbiota. Rapid and easy-to-implement tests to assess microbiome profiles and metabolites associated with sepsis could revolutionize the disease’s diagnosis and management. These approaches could not only improve patient prognosis but also reduce dependence on antibiotic therapies and promote more targeted and sustainable treatment strategies. Nevertheless, there is still limited clarity regarding the ideal composition of the microbiota, which should be further characterized in the near future. Similarly, the benefits of therapeutic approaches should be validated through additional studies. Full article
(This article belongs to the Special Issue New Diagnostic and Therapeutic Trends in Sepsis and Septic Shock)
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