Journal of Diagnostics Concepts & Practice ›› 2025, Vol. 24 ›› Issue (06): 583-592.doi: 10.16150/j.1671-2870.2025.06.003

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Current status and challenges in sepsis diagnosis and treatment

HUANG Man1,2(), DING Shuo1,2   

  1. 1. Department of General Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhe jiang Hangzhou 310051, China
    2. Key Laboratory of Multiple Organ Failure (Zhejiang University), Ministry of Education, Zhejiang Hangzhou 310051, China
  • Received:2025-10-10 Revised:2025-11-20 Online:2025-12-25 Published:2025-12-25
  • Contact: HUANG Man E-mail:huangman@zju.edu.cn

Abstract:

Sepsis leads to approximately 11 million deaths globally each year, and its incidence is still on the rise, particularly in aging societies. Elderly patients, due to multiple underlying diseases and declined immune function, often progress rapidly to sepsis after infection, resulting in poor prognosis. Additionally, immunosuppressed patients, such as those who have undergone organ transplantation or have malignant tumors, exhibit a significantly higher incidence of sepsis compared to the general population. From 2017 to 2019, the annual standardized incidence of sepsis among hospitalized patients in China was (328.25-421.85) per 100 000, with over 57% of cases occurring in individuals aged 65 and above. As a syndrome of organ dysfunction caused by a systemic hyperinflammatory response to infection, sepsis remains a significant disease contributing to high mortality and healthcare burden worldwide. Although diagnostic and therapeutic strategies have been continuously improved with in-depth research on sepsis mechanisms in recent years, clinical practice still faces several core challenges: ① difficulties in early diagnosis due to limitations of current assessment systems and biomarkers; ② increasingly severe antibiotic resistance, which significantly restricts treatment options; and ③ extremely high heterogeneity of the disease, which leads to poor efficacy of standardized treatment schemes and limited adoption of individualized therapy. In recent years, at the diagnostic level, the application of novel biomarkers, molecular diagnostic technologies, and artificial intelligence is driving innovations in early identification and precise subtyping capabilities. At the therapeutic level, the concepts of individualized and precision medicine are increasingly applied, and novel therapeutic strategies such as immunomodulation demonstrate great potential in addressing disease complexity. The key to overcoming the above three core challenges lies in integrating the concept of precision medicine throughout the entire diagnostic and therapeutic process: by leveraging multi-omics data to deepen the understanding of disease heterogeneity, utilizing advanced technologies to achieve accurate diagnosis and subtyping, and developing targeted therapies based on this foundation, ultimately achie-ving the goal of improving patient prognosis.

Key words: Sepsis, Diagnosis, Treatment, Biomarkers, Antibiotic resistance, Precision medicine

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