Role of biomarkers in pediatric sepsis: What evidence says?

Table 2 Study details depicting various biomarkers for pediatric sepsis

Country	Sample size	Age group	Biomarker	Main results			Cut-off value	Remarks	Ref.
				AUC value	Sensitivity (%)	Specificity (%)
India	124 patients	From 1 month to 15 years	PCT (day 0)	0.604	81.8	80.8	> 3.0 ng/mL	This study highlights PCT as a more reliable predictor than CRP for pediatric sepsis, especially in determining disease severity and guiding clinical management	Tyagi et al[12], 2024
			PCT (day 3)	0.993	86.2	89.8
			CRP (day 0)	0.848	63.6	61.0	10 mg/dL
			CRP (day 3)	0.85	84.7	62.8
Canada	20 sepsis patients	Median age 13 years	IL-6, IL-8, IL-10	1.00	-	-	95%CI: 1.00-1.00	P < 0.001	Leonard et al[5], 2024
			CRP	0.804	49.2	89.5	≥ 2.0 mg/dL	-
			PCT	0.746	54.1	87.5	≥ 0.3 ng/mL
Latvia	165 patients	From 1 month to 18 years	CRP	CRP of 0.799, PCT and IL-6 < CRP	83.0	65.0	69.9 mg/mL	The combination of CRP and sFAS enhanced sepsis prediction sensitivity over CRP alone, while the multi-biomarker panel of CRP, PCT, IL-6, sFAS, and sVCAM-1 achieved the highest AUC among all tested models	Rautiainen et al[13], 2022
			PCT		87.0	57.0	0.43 ng/mL
			G-CSF		28.0	83.0	61.58 pg/mL
			Eotaxin		51.0	69.0	61.77 pg/mL
			IL-10		51.0	68.0	23.03 pg/mL
			IL-8		45.0	77.0	21.90 pg/mL
			IL-6		86.0	46.0	18.30 pg/mL
			sVCAM-1		83.0	33.0	868 pg/mL
			sFAS		79.0	44.0	2538.29 pg/mL
United States	194 patients	From 1 month to 18 years	IL-8	0.68	72%	74%	43.5-209.5 pg/mL (survivors), 101-436 pg/mL (non-survivors)	Strongest significance of P < 0.001	Zinter et al[14], 2017
Multicenter, 8 European countries	38,480 children (17082 with WBC values)	0-18 years	WBC, ANC, CRP	0.71, 0.84, 0.71	56%, 32%, 87%, 55%, 55%	74%, 91%, 59%, 91%, 75%	WBC > 15000, WBC > 20000, CRP > 20, CRP > 80, ANC > 10	WBC is significantly associated with SBI; however, WBC does not have a diagnostic benefit than CRP in identifying children with SBI	Kemps et al[15], 2025
Brazil	350 patients	From 6 months to 18 years	CRP	0.648	-	-	> 6.5 mg/mL	In pediatric sepsis patients over six months old, ferritin, lactate, and CRP individually demonstrated strong prognostic value for mortality, and when combined, they predicted fatal outcomes in 75% of cases, whereas total leukocyte count lacked prognostic utility	Tonial et al[16], 2020
			Ferritin	0.785			> 135 ng/mL
			Lactate	0.762			> 1.7 mmol/L
			Leukocytes	0.508			-

ANC: Absolute neutrophil count; AUC: Area under the curve; CRP: C-reactive protein; IL: Interleukin; PCT: Procalcitonin; SBI: Serious bacterial infections; sFAS: Soluble FAS; sVCAM-1: Soluble vascular cell adhesion molecule-1; WBC: White blood cell.