Global experts unpack challenges and breakthroughs in sepsis laboratory diagnostics

Sepsis remains one of the most pressing yet under-recognized global health crises, responsible for at least 11 million deaths annually—one every 2.8 seconds. It affects up to 50 million people each year, making it a leading cause of death worldwide. Despite these staggering figures, sepsis has yet to receive the same level of political attention and funding as other major health concerns like HIV, malaria, or antimicrobial resistance (AMR).

Against this backdrop, SelectScience^® recently hosted an Advancing Healthcare Forum, a live panel discussion titled Global Perspectives on Sepsis Diagnostics and Management. The expert panel featured Dr. Ron Daniels, CEO of the UK Sepsis Trust; Dr. Ephraim Tsalik, VP and Chief Scientific Officer at Danaher Diagnostics; and Dr. Mariam Jashi, CEO of the Global Sepsis Alliance.

Moderated by Sonia Nicholas, Managing Editor and Clinical Lead for SelectScience, the discussion tackled critical challenges in sepsis diagnostics, the role of new technologies, and the urgent need for systemic change at both the clinical and policy levels.

The elusive nature of sepsis laboratory diagnostics

One of the biggest challenges in diagnosing sepsis is that there is no definitive "sepsis test." Unlike conditions with clear biomarkers or imaging tools, sepsis is defined as a dysregulated immune response to infection, which can present in countless ways. Dr. Daniels highlighted that the key to improving sepsis diagnostics lies in breaking the process into three core categories:

• Identifying inflammation: A baseline test must first determine if inflammation is present.
• Distinguishing infection: Next, clinicians need to determine whether the inflammation stems from an infection or a noninfectious cause.
• Risk stratification and pathogen identification: Finally, diagnostic tools must assess the severity of the condition, predict potential deterioration, and identify the causative pathogen to guide targeted treatment.

The lack of a single, definitive test complicates efforts to standardize sepsis laboratory diagnostics across healthcare systems. Daniels emphasized that even though technology has rapidly advanced, the process of integrating these diagnostics into clinical practice remains slow and inconsistent.

The role of new technologies and AI in sepsis detection

Dr. Tsalik pointed to recent advancements in diagnostic technology that could significantly improve how sepsis is detected and managed. The rise of omics-based approaches—including genomics, proteomics, and metabolomics – has provided researchers with deeper insights into the biology of sepsis. Combined with machine learning, these tools have the potential to identify sepsis earlier and more accurately.

However, the challenge isn’t just in developing these tests, but in proving their clinical utility. “A new diagnostic is not enough. You have to demonstrate that using this test leads to better patient outcomes,” Tsalik explained. This means proving that a test can reduce ICU/ITU stays, decrease mortality, and improve antibiotic stewardship.

Another important consideration is the practical implementation of these technologies. Many laboratories, especially in low-resource settings, lack the personnel or infrastructure to adopt complex new diagnostic tests. Even in high-income countries, laboratories are often stretched thin, making it difficult to introduce additional testing without overwhelming existing workflows.

The need for political and systemic change

While advancements in diagnostics are crucial, Dr. Jashi, CEO of the Global Sepsis Alliance, stressed that technological innovation alone won’t solve the sepsis crisis. A key reason why sepsis remains under-prioritized is the lack of political commitment to addressing it at a global level. “Without political transformation, there won’t be enough financial investment to scale up new technologies for early detection and treatment,” she said.

Jashi pointed out that sepsis is deeply intertwined with other global health priorities, including AMR, maternal and neonatal health, and pandemic preparedness. Yet, despite these links, sepsis has been largely absent from major health discussions. “Even in the COVID-19 pandemic response, where 80% of ICU patients had viral sepsis, we didn’t see sepsis included as a major part of pandemic preparedness strategies,” she noted.

To address this, the Global Sepsis Alliance launched the 2030 Global Agenda for Sepsis, the first long-term strategy for reducing the burden of sepsis worldwide. The agenda outlines key policy and research priorities, including the need for better integration of diagnostics, increased funding for sepsis research, and improved public awareness campaigns.

Barriers to implementation and solutions

One recurring theme throughout the discussion was the difficulty of integrating sepsis diagnostics into clinical practice. Daniels noted that in many healthcare systems, particularly in centralized laboratory models like the UK, logistical barriers delay test results. Even if a diagnostic assay itself is rapid, the process of transporting a sample, running the test, and communicating results can take too long for critically ill patients.

To address these challenges, panelists emphasized the need for more decentralized and point-of-care testing. AI-driven diagnostics could also help clinicians interpret test results more efficiently, particularly in settings with fewer specialized sepsis experts. Daniels suggested that an “algorithmic approach” could empower generalist clinicians to make better decisions: “It needs to be as simple as, ‘If the patient does not look sick and test X is below value Y, then withhold antibiotics.’”

Lessons from the COVID-19 pandemic

The discussion also explored how lessons from COVID-19 could be applied to sepsis laboratory diagnostics. Tsalik noted that the pandemic demonstrated both the strengths and weaknesses of global diagnostic infrastructure. On one hand, it showcased the power of rapid diagnostics, public awareness campaigns, and large-scale research initiatives. On the other, much of the diagnostic infrastructure built for COVID-19 has now been dismantled, missing an opportunity to repurpose it for broader infectious disease management.

Daniels pointed out that public familiarity with rapid testing could be leveraged to improve sepsis detection: “Many people now understand the lateral flow test - why not build on that understanding to improve diagnostics for bacterial and viral infections?” However, he expressed frustration that much of the progress made in diagnostic accessibility during COVID-19 has not been sustained.

The path forward for laboratory sepsis diagnostics

As the forum drew to a close, Jashi called on laboratory professionals, clinicians, and policymakers to take an active role in pushing the sepsis agenda forward. She urged professionals to engage with the 2030 Global Agenda for Sepsis, participate in education initiatives like the World Sepsis Congress, and advocate for greater investment in diagnostics.

“Every hour of delayed treatment increases mortality risk. If we improve early detection and management, we can prevent millions of deaths,” she said.

The discussion made it clear that while sepsis remains a complex and multifaceted challenge, progress is within reach. With continued advancements in diagnostics, stronger global policies, and increased public awareness, the future of sepsis care could look very different by 2030.