New ways of approaching sepsis will improve patient outcomes

The overall observed increase in cases has been attributed to individuals living into older age, with approximately 60 percent to 85 percent of sepsis cases occurring in patients older than 65 years.3 Globally, a concerted effort has been made to raise sepsis awareness, as projections indicate that the incidence and associated costs of sepsis will continue to increase in the future. In tissue hypoxia, lactate is overproduced via increased anaerobic glycolysis and worsens if liver dysfunction and acute kidney injury occur due to a decreased ability to clear lactate from the body.11 Viral and fungal detection The majority of sepsis cases are bacterial, and the discernment of bacterial from fungal, or in rare cases viral, sepsis is of importance for appropriate therapy selection and antimicrobial stewardship. For the IFI27 biomarker, an increased IFI27 gene expression in peripheral blood indicates an immune response to particular respiratory viruses.13 As for the myxoma resistance protein 1 (MxA), it is induced during viral infections as well, so MxA testing could be helpful in differentiating between viral and bacterial infections. Serum monitoring of galactomannan can potentially allow initiation of antifungal therapy before life threatening infection occurs.15 1-3-ß-D glucan (BDG) offers another potential target, because it is found as a cell wall component in most fungi, with the exception of the cryptococci, the zygomycetes, and Blastomyces dermatitidis.16 Cytokines and cell surface receptors Inflammatory marker investigations have been difficult because these markers are shared across a variety of inflammatory conditions and disease states.