Daily Sepsis Research Analysis

During surgery, purulent fluid containing pathogens may be found at the surgical site. Pathogens in purulent fluid can cause sepsis if disseminated into the bloodstream. Therefore, intraoperative detection of pathogens in purulent fluid is critical for guiding surgeons in selecting surgical management and antibiotic therapy. However, current detection methods are either time-consuming or unable to identify live pathogens, restricting their clinical application in intraoperative settings. To overcome these limitations, we proposed an intraoperative pathogen rapid detection (IPRD) method. This method can simultaneously detect the presence, viable fraction, species, and concentrations of multiple pathogens in 15 min. This method is performed on a chip with two parts: a single-channel part combines live/dead staining with AI-assisted microscopy to quantify live pathogens, and a parallel-channel part uses electroporation-based lysis followed by LAMP assay for nucleic acid detection. This method demonstrated an accuracy of 99.01 % in clinical validation, reliably detecting Candida albicans, Escherichia coli, and Enterococcus faecalis at 10

BACKGROUND: Sepsis and septic shock are life-threatening conditions driven by dysregulated host responses to infection, resulting in multi-organ dysfunction. While early fluid resuscitation is essential, both fluid overload and under-resuscitation can worsen outcomes. Left Ventricular Outflow Tract Velocity Time Integral (LVOT VTI) has emerged as a non-invasive echocardiographic tool to assess fluid responsiveness. This systematic review evaluates the diagnostic performance, cutoff values, and limitations of LVOT VTI as a tool for assessing fluid responsiveness in adult patients with sepsis or septic shock. METHODS: A systematic search of PubMed, Cochrane, Scopus, Web of Science, EMBASE, and CINAHL was conducted through April 13, 2025, following PRISMA 2020 guidelines (PROSPERO ID: CRD420251036927). Eligible studies used transthoracic or transesophageal echocardiography to measure LVOT VTI and assessed changes following passive leg raise (PLR) or volume expansion tests (VET). Fluid responsiveness was defined as a ≥ 10-15% increase in VTI. RESULTS: Three observational studies including 199 adult patients (20 with sepsis, 179 with septic shock) met inclusion criteria. Two studies used VET (500 mL saline), and one used PLR. Optimal LVOT VTI cutoffs ranged from > 7% to 16%, with sensitivity 78-96%, specificity 91-100%, and AUCs 0.84-0.99. Based on the Newcastle-Ottawa Scale, two studies were rated good quality, and one was fair. CONCLUSION: LVOT VTI is a reliable, non-invasive parameter for assessing fluid responsiveness in sepsis and septic shock. Despite limited data, this review supports its integration into bedside fluid management protocols to guide individualized resuscitation strategies. PROSPERO REGISTRATION ID: CRD420251036927.

BACKGROUND: COVID-19, sepsis, and septic shock are associated with significant endothelial dysfunction and capillary leakage, posing diagnostic and management challenges in critically ill patients. Capillary leakage, as reflected by the albumin transudation rate (ATR), may have implications for fluid dynamics and patient outcomes in these conditions. We sought to describe and compare ATR in these two related pathologies, but clinically distinct conditions. METHODS: This study was conducted in 2022 across three ICUs and included 36 patients (18 with COVID-19 and 18 with sepsis). The local ethical committees approved the study. ATR, total blood volume (TBV), red blood cell volume (RBCV), and plasma volume (PV) were measured at multiple time points (Days 1, 2, 3, 7, and 10) using a RESULTS: ATR was significantly higher in patients with sepsis compared to those with COVID-19 throughout the ICU stay, despite lower admission severity scores in the sepsis group. Clinical assessments of the volume status frequently misclassify TBV in patients with COVID-19 or sepsis. Patients were often deemed hypervolemic when, by objective measures, they were hypovolemic under both conditions. CONCLUSION: ATR was persistently elevated in critically ill patients with sepsis and COVID-19. Sepsis exhibited significantly higher ATR values, suggesting a more pronounced endothelial dysfunction. There is a frequent inaccuracy in clinical fluid status assessment, which demands more reliable diagnostic tools to better guide fluid therapy in critically ill patients.