The Role of Biomarkers in the Diagnosis and Management of Severe Infections in the Critically Ill

Document Type

Article

Publication Date

6-22-2026

Publication Title

Critical Care Nursing Clinics of North America

Abstract

The diagnosis and management of critically ill patients with severe infection is complex. Severe infections in critically ill populations is a leading cause of morbidity and mortality in the United States and includes sepsis, drug resistant infections, opportunistic infections in immunocompromising illness (eg, cancer, human immunodeficiency virus), community acquired pneumonia (viral and bacterial), ventilator-associated pneumonia, complicated genitourinary infection, and others.1 The clinical evaluation methods through a comprehensive history collection and physical examination does not yield enough diagnostic data to identify the pathogen(s), control the source of infection, or monitor the progress or deterioration of the patient’s condition. Diagnostic tests, like biomarkers of the patient’s inflammatory response to infection, can be used to monitor a patient’s severity of illness, response to pharmacotherapies, and disease progression. Biomarker monitoring also has predictive or prognostic value in patient evaluation and management.2 Biomarkers, also known as biological markers, must be included in the repeated evaluation and management of severe infections to support timely, efficient, and effective diagnosis and therapeutic management. Each tissue in the body has a unique biomolecular composition, known as its set of biomarkers. Biomarkers are characterized by specific features such as the levels or activities of genes, proteins, or other biomolecules involved in biological functions.3 Examples of biomarkers include measurements such as blood pressure and body temperature, serum blood tests, and imaging biomarkers that can identify fractures or tumors. Biomarkers can be classified according to several distinct factors including their functions and properties. Host response and pathogen specific biomarkers are increasingly used in critically ill patients with serious or life-threatening infections in the intensive care unit (ICU) to support clinical judgment and strengthen the interpretation of other diagnostic and prognostic tests. The focus of this article will be on the biomarkers used to evaluate severe infection in critically ill populations across the lifespan.

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