Required section · Section 6 of 6

What the biomarkers support and what remains uncertain

Lactate contributes a time-sensitive perfusion and metabolic-stress signal. PCT contributes a kinetic inflammatory signal with assay, renal, dialysis, and noninfectious limitations. CRP contributes a nonspecific acute-phase signal that is particularly vulnerable to early timing error.

Emerging markers need explicit evidence labels. Presepsin, soluble triggering receptor expressed on myeloid cells 1, and interleukin-6 have variable evidence maturity and no verified standalone FDA clearance as sepsis diagnostics in this review. The FDA-authorized Sepsis ImmunoScore is a multi-biomarker and clinical-variable algorithm, not a new single-analyte cutoff.

Current 2026 sepsis guidance frames currency, while the biomarker-specific recommendations used here are attributed to the accessible 2021 guideline. Local policy must set critical-value thresholds, result notification, assay-specific interpretation, method comparability, and any PCT protocol. Release accurate measurement and context, then leave diagnosis and treatment decisions to the clinical team using the full evidence.

Three labeled rows identify lactate, PCT, and CRP as established adjuncts; presepsin, soluble TREM-1, and IL-6 as evidence maturing; and Sepsis ImmunoScore as an algorithm rather than a single analyte. — Figure 1Evidence labels distinguish established adjuncts, maturing markers, and a multi-marker algorithm without implying diagnostic certainty.

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Local policy defines critical values, notification, and method-comparability practice.

Emerging markers should carry evidence-maturity and regulatory-status labels.

One PCT cutoff should direct every laboratory antibiotic protocol.

Any FDA-authorized algorithm makes a single biomarker diagnostic.

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