Role of biomarkers in pediatric sepsis: What evidence says?

Table 1 Overview of biomarkers in pediatric sepsis

Biomarker	Type	Reference range	Advantages	Limitations	Ref.
C-reactive protein	Acute phase protein	< 10 mg/L	Cost-effective, high availability, helpful for fungal infection detection, unaffected by immune suppression effects	Low accuracy, variable sensitivity and specificity for detecting bacterial infection	Lim et al[9]
Procalcitonin	Peptide hormone	0.5-2.0 ng/mL	High specificity and sensitivity, more specifically, for bacterial infection, moderate prognostic value	Costly, variable threshold values for various infections, altered serum levels in cases of renal dysfunction, variable sensitivity, and specificity	Lim et al[9]
Ferritin	Acute phase protein	20-200 ng/mL	Potential use for real-time treatment adjustments	Low specificity and sensitivity, elevated in various inflammatory and liver conditions, not specific to sepsis	Lim et al[9], Tonial et al[10]
IL-6	Cytokine	< 7 pg/mL	Promising use in pediatric patients with cancer and febrile neutropenia, key proinflammatory cytokine in the immune response	Few studies in the pediatric population. Low availability, high cost, low specificity, and sensitivity	Z Oikonomakou et al[7], Esposito et al[11]
IL-8	Cytokine	≤ 220 pg/mL	Exhibits prognostic value for pediatric sepsis	Complex interpretation, variability among patients, moderate sensitivity, and specificity	Z Oikonomakou et al[7], Esposito et al[11]
IL-10	Cytokine	< 5 pg/mL	Demonstrates good sensitivity and specificity	limited by variability in expression	Z Oikonomakou et al[7], Esposito et al[11]
Lactate	Metabolic marker	0.5-2.2 mmol/L	Elevated levels suggest impaired oxygen delivery and utilization	Low accuracy for sepsis detection, levels can be elevated in conditions other than sepsis, such as trauma or liver dysfunction	Tonial et al[10], Esposito et al[11]
Leukocytes	Hematological parameter	5000-15000 cells/μL	Inexpensive and quick to obtain	Changes in white blood cell count can occur due to various non-infectious conditions	Z Oikonomakou et al[7]
TNF-related apoptosis-inducing ligand	Apoptosis regulator	40-60 pg/mL	Play a role in prognostication	Limited pediatric-specific data, variability and standardization issues	Z Oikonomakou et al[7], Tonial et al[10]
TNF-α	Cytokine	< 8 pg/mL	Helpful in the early detection of sepsis	Lack of specificity, variable sensitivity	Z Oikonomakou et al[7], Tonial et al[10]

IL: Interleukin; TNF: Tumor necrosis factor.