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Calprotectin as a sepsis diagnostic marker in critical care : a retrospective observational study

Lengquist, Maria LU orcid ; Sundén-Cullberg, Vera ; Hyllner, Sofie ; Koozi, Hazem LU ; Larsson, Anders ; Mellhammar, Lisa LU ; Friberg, Hans LU ; Schiopu, Alexandru LU orcid and Frigyesi, Attila LU (2025) In Scientific Reports 15(1).
Abstract

Diagnosing sepsis in critical care remains a challenge due to the lack of gold-standard diagnostics. Calprotectin (S100A8/A9) has been proposed as a diagnostic marker to identify sepsis in critically ill patients. This study evaluated the diagnostic performance of calprotectin and C-reactive protein (CRP) to distinguish between sepsis and non-sepsis on intensive care unit (ICU) admission. Admission biobank blood samples from adult patients admitted to four ICUs (2015–2018) were used to analyse calprotectin and CRP. All adult patients were screened retrospectively for the sepsis-3 criteria at ICU admission. The diagnostic performance of calprotectin and CRP was evaluated using receiver operating characteristic (ROC) curves. We included... (More)

Diagnosing sepsis in critical care remains a challenge due to the lack of gold-standard diagnostics. Calprotectin (S100A8/A9) has been proposed as a diagnostic marker to identify sepsis in critically ill patients. This study evaluated the diagnostic performance of calprotectin and C-reactive protein (CRP) to distinguish between sepsis and non-sepsis on intensive care unit (ICU) admission. Admission biobank blood samples from adult patients admitted to four ICUs (2015–2018) were used to analyse calprotectin and CRP. All adult patients were screened retrospectively for the sepsis-3 criteria at ICU admission. The diagnostic performance of calprotectin and CRP was evaluated using receiver operating characteristic (ROC) curves. We included 4732 patients, of whom 44% had sepsis. Calprotectin levels were higher in sepsis (p < 0.001). The area under the receiver operating curve (AUROC) to diagnose sepsis was 0.61 for calprotectin compared to 0.72 for CRP (p < 0.001). Among microbiological subgroups of sepsis patients, fungal sepsis had the highest level of calprotectin. We conclude that the diagnostic performance of calprotectin in identifying sepsis patients at ICU admission was inferior to that of CRP.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Biomarkers, C-reactive protein, Critical care, Infections, Leukocytes, S100 Proteins, Sepsis, Septic, Shock
in
Scientific Reports
volume
15
issue
1
article number
15529
publisher
Nature Publishing Group
external identifiers
  • pmid:40319081
  • scopus:105004050679
ISSN
2045-2322
DOI
10.1038/s41598-025-95420-0
language
English
LU publication?
yes
id
20d6e5d5-f5c6-405f-ac0d-11588d8cc3b7
date added to LUP
2025-07-14 12:12:36
date last changed
2025-07-14 12:13:06
@article{20d6e5d5-f5c6-405f-ac0d-11588d8cc3b7,
  abstract     = {{<p>Diagnosing sepsis in critical care remains a challenge due to the lack of gold-standard diagnostics. Calprotectin (S100A8/A9) has been proposed as a diagnostic marker to identify sepsis in critically ill patients. This study evaluated the diagnostic performance of calprotectin and C-reactive protein (CRP) to distinguish between sepsis and non-sepsis on intensive care unit (ICU) admission. Admission biobank blood samples from adult patients admitted to four ICUs (2015–2018) were used to analyse calprotectin and CRP. All adult patients were screened retrospectively for the sepsis-3 criteria at ICU admission. The diagnostic performance of calprotectin and CRP was evaluated using receiver operating characteristic (ROC) curves. We included 4732 patients, of whom 44% had sepsis. Calprotectin levels were higher in sepsis (p &lt; 0.001). The area under the receiver operating curve (AUROC) to diagnose sepsis was 0.61 for calprotectin compared to 0.72 for CRP (p &lt; 0.001). Among microbiological subgroups of sepsis patients, fungal sepsis had the highest level of calprotectin. We conclude that the diagnostic performance of calprotectin in identifying sepsis patients at ICU admission was inferior to that of CRP.</p>}},
  author       = {{Lengquist, Maria and Sundén-Cullberg, Vera and Hyllner, Sofie and Koozi, Hazem and Larsson, Anders and Mellhammar, Lisa and Friberg, Hans and Schiopu, Alexandru and Frigyesi, Attila}},
  issn         = {{2045-2322}},
  keywords     = {{Biomarkers; C-reactive protein; Critical care; Infections; Leukocytes; S100 Proteins; Sepsis; Septic; Shock}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Calprotectin as a sepsis diagnostic marker in critical care : a retrospective observational study}},
  url          = {{http://dx.doi.org/10.1038/s41598-025-95420-0}},
  doi          = {{10.1038/s41598-025-95420-0}},
  volume       = {{15}},
  year         = {{2025}},
}