Fig 1.
Definitions of verified bacterial sepsis, severe bacterial sepsis, and bacterial septic shock according to Sepsis-2 and Sepsis-3, respectively.
SIRS, systemic inflammatory response syndrome; MAP, mean arterial pressure.
Fig 2.
Distribution of 1,572 episodes of adult patients with suspected sepsis depending on presence of bacterial infection and whether the criteria for Sepsis-2 and/or Sepsis-3 were fulfilled.
Fig 3.
Comparisons of levels of single biomarkers stratified by patient categories.
i. Others (i.e., non-verified bacterial infection, viral infection, and no infection) (n = 698); ii. Verified bacterial infection (n = 874); iii. Verified bacterial sepsis (Sepsis-2) (n = 667); iv. Verified severe bacterial sepsis/septic shock (Sepsis-2) (n = 169); v. Verified bacterial sepsis (Sepsis-3) (n = 560). (A) Procalcitonin (PCT), (B) C-reactive protein (CRP), (C) Lactate, (D) Neutrophil-lymphocyte count ratio (NLCR).
Table 1.
Patient characteristics at admission.
Fig 4.
AUC for the biomarkers evaluated in the present study.
Error bars represent 95% CI. The red dotted lines represent a reference line corresponding to AUC = 0.5. The three-biomarker consists of a combination of CRP, lactate, and NLCR, whereas the four-biomarker consists of a combination of PCT, CRP, lactate, and NLCR. (A) AUC for diagnosis of bacteraemia. (B) AUC for diagnosis of verified bacterial infection. (C) AUC for diagnosis of verified bacterial sepsis using Sepsis-2 criteria irrespective severity (i.e., sepsis, severe sepsis, and septic shock). (D) AUC for diagnosis of verified severe bacterial sepsis/septic shock using Sepsis-2 criteria. (E) AUC for diagnosis of verified bacterial sepsis using Sepsis-3 criteria irrespective severity (i.e., sepsis and septic shock). AUC, area under receiver operating caracteristic curve; CI, confidence interval; CRP, C reactive protein; NLCR, neutrophil-lymphocyte ratio; PCT, procalcitonin.
Table 2.
Performance characteristics of single biomarkers for diagnosing verified bacterial sepsis using Sepsis-2 criteriaa.
Table 3.
Performance characteristics of single biomarkers for diagnosing verified severe bacterial sepsis/bacterial septic shock using Sepsis-2 criteria.
Table 4.
Performance characteristics of single biomarkers for diagnosing verified bacterial sepsis using Sepsis-3 criteriaa.