Sepsis is a life-threatening whole-body inflammatory reaction caused by a severe infection. With mortality rates around 35%, sepsis is responsible for 11 million deaths worldwide every year. The window of opportunity for sepsis management is in hours: the chance of survival drops by 7.6% each hour of disease progression until an appropriate treatment is started. Early and accurate sepsis detection and stratification is essential for enhancing survival rates. However, this is challenging, due to: i) complex diagnostic criteria requiring screening of multiple targets including both biomarkers and pathogens, (ii) time-consuming laboratory methods for identifying the bacterial causes of sepsis. Even worse, the currently used conventional immunoassay techniques are performed in centralized laboratories, causing extra delays due to specimen transfers. In a nutshell, the unmet needs that next-generation sepsis diagnostics must address are:
- Multiplexed biosensing for multiple disease biomarkers and bacteria,
- Ultrafast response (less than 20 min) with high sensitivity and specificity,
- Simplified measurement process (no sample preparation/label free),
- Intelligent analysis of sensory results for classification of sepsis events and decision making for therapy,
- Mobility for diagnosis and disease progression assessment at the point of care.
Meeting this challenging framework can only be accomplished through the adoption of real-time and label-free sensor technologies that can provide high sensitivities even in small-footprint layouts. Towards this direction, integrated plasmo-photonic refractive index (RI) sensors comprise definitely the most promising candidate platform.