Rapid and Differential Diagnosis of Sepsis Stages Using an Advanced 3D Plasmonic Bimetallic Alloy Nanoarchitecture-Based SERS Biosensor Combined with Machine Learning for Multiple Analyte Identification.

Summary

A 3D Au-Ag nanopillar SERS platform quantify four immune markers (CD123, PD-L1, HLA-DR, ChiT) in serum with 4–6 fM LOD and excellent reproducibility. Coupled with SVM, it classified healthy, infection (with/without sepsis), and septic shock with 95.0% accuracy and 95.8% precision, enabling rapid multi-marker sepsis staging.

Key Findings

• 3D Au-Ag alloy nanopillar SERS chip fabricated via AAO provides uniform, reproducible nanogaps for one-step, multiplex serum analysis.
• Ultra-low detection limits (4–6 fM) and high signal consistency (RSD 1.79%) for CD123, PD-L1, HLA-DR, and ChiT.
• SVM-based classification achieved 95.0% accuracy and 95.8% precision across healthy, infection with/without sepsis, and septic shock.

Clinical Implications

If prospectively validated, this platform could support rapid ED triage, differentiate sepsis severity, and guide personalized therapy, potentially reducing unnecessary antibiotics and ICU admissions.

Limitations

• Clinical sample size and cohort characteristics are not detailed; external and prospective validation are lacking
• Comparative performance versus standard biomarkers (e.g., procalcitonin, CRP) in real-world pathways is not reported

Future Directions

Conduct multicenter, prospective diagnostic accuracy and impact studies, head-to-head with standard biomarkers and clinical scores, including workflow, cost-effectiveness, and regulatory validation.