Towards novel BIOmarkers to diagnose SEPsis (BIOSEP) in the emergency room: a protocol for a multicentre, prospective cohort study

Introduction The international Surviving Sepsis Campaign guidelines highlight the need for recognising sepsis in a timely and accurate manner. Early diagnosis and treatment of sepsis are crucial and associated with reduced mortality. In the early stages of sepsis, heterogeneous clinical signs are di...

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Main Authors: Tom van der Poll, W Joost Wiersinga, Michiel Schinkel, Renee A Douma, Hazra S Moeniralam, Marleen A Slim, Evelien Reijnders, Oren Turgman, Sebastiaan C M Joosten, Hessel Peters-Sengers
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/7/e103138.full
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author Tom van der Poll
W Joost Wiersinga
Michiel Schinkel
Renee A Douma
Hazra S Moeniralam
Marleen A Slim
Evelien Reijnders
Oren Turgman
Sebastiaan C M Joosten
Hessel Peters-Sengers
author_facet Tom van der Poll
W Joost Wiersinga
Michiel Schinkel
Renee A Douma
Hazra S Moeniralam
Marleen A Slim
Evelien Reijnders
Oren Turgman
Sebastiaan C M Joosten
Hessel Peters-Sengers
author_sort Tom van der Poll
collection DOAJ
description Introduction The international Surviving Sepsis Campaign guidelines highlight the need for recognising sepsis in a timely and accurate manner. Early diagnosis and treatment of sepsis are crucial and associated with reduced mortality. In the early stages of sepsis, heterogeneous clinical signs are difficult to interpret, often leading to missed or delayed diagnoses, as well as inappropriate or late use of antibiotics. There is an urgent need to quickly and accurately identify patients with potential infection in the emergency department (ED) who are at risk of progressing along the infection-sepsis spectrum. This study aims to compare the immune responses of ED patients presenting with a (suspected) infection, both with and without sepsis, to gain insights into immune aberrations and identify novel biomarkers linked to an increased risk of developing sepsis and its sequelae.Methods and analysis A prospective observational cohort study across three hospitals in the Netherlands will be conducted. Adults presenting to the ED of these hospitals, with a (suspected) infection and a Modified Early Warning Score of 2 or higher, will be eligible for enrolment. We aim to include up to 3330 patients. The main study parameters will be characterisation of the host immune and metabolic response using multiomics analysis, Raman spectroscopy, mass spectrometry and gut microbiota profiling in relation to clinical outcomes such as 30-day mortality, length of hospital stay, readmission and postsepsis sequelae.Ethics and dissemination Verbal and written informed consent will be obtained from all participants or their legal representatives. The study was approved by the Amsterdam University Medical Centre Ethics Committee (No. 2022.0279) and will adhere to the Declaration of Helsinki and the Medical Research Involving Human Subjects Act (WMO). Research results will be published in peer-reviewed journals.Trail registration number ClinicalTrials.gov, NCT06178822.
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spelling doaj-art-b71d6b0e4da24a75b29ddfefa1ad62c92025-08-20T03:58:10ZengBMJ Publishing GroupBMJ Open2044-60552025-08-0115710.1136/bmjopen-2025-103138Towards novel BIOmarkers to diagnose SEPsis (BIOSEP) in the emergency room: a protocol for a multicentre, prospective cohort studyTom van der Poll0W Joost Wiersinga1Michiel Schinkel2Renee A Douma3Hazra S Moeniralam4Marleen A Slim5Evelien Reijnders6Oren Turgman7Sebastiaan C M Joosten8Hessel Peters-Sengers9Center for Infection and Molecular Medicine, Amsterdam UMC Location AMC, Amsterdam, The NetherlandsCenter for Infection and Molecular Medicine, Amsterdam UMC Location AMC, Amsterdam, The NetherlandsCenter for Infection and Molecular Medicine, Amsterdam UMC Location AMC, Amsterdam, The NetherlandsDepartment of Internal Medicine, Flevo Hospital, Almere, The NetherlandsDepartment of Internal Medicine, Sint Antonius, Nieuwegein, The NetherlandsCenter for Infection and Molecular Medicine, Amsterdam UMC Location AMC, Amsterdam, The NetherlandsCenter for Infection and Molecular Medicine, Amsterdam UMC Location AMC, Amsterdam, The NetherlandsCenter for Infection and Molecular Medicine, Amsterdam UMC Location AMC, Amsterdam, The NetherlandsCenter for Infection and Molecular Medicine, Amsterdam UMC Location AMC, Amsterdam, The NetherlandsCenter for Infection and Molecular Medicine, Amsterdam UMC Location AMC, Amsterdam, The NetherlandsIntroduction The international Surviving Sepsis Campaign guidelines highlight the need for recognising sepsis in a timely and accurate manner. Early diagnosis and treatment of sepsis are crucial and associated with reduced mortality. In the early stages of sepsis, heterogeneous clinical signs are difficult to interpret, often leading to missed or delayed diagnoses, as well as inappropriate or late use of antibiotics. There is an urgent need to quickly and accurately identify patients with potential infection in the emergency department (ED) who are at risk of progressing along the infection-sepsis spectrum. This study aims to compare the immune responses of ED patients presenting with a (suspected) infection, both with and without sepsis, to gain insights into immune aberrations and identify novel biomarkers linked to an increased risk of developing sepsis and its sequelae.Methods and analysis A prospective observational cohort study across three hospitals in the Netherlands will be conducted. Adults presenting to the ED of these hospitals, with a (suspected) infection and a Modified Early Warning Score of 2 or higher, will be eligible for enrolment. We aim to include up to 3330 patients. The main study parameters will be characterisation of the host immune and metabolic response using multiomics analysis, Raman spectroscopy, mass spectrometry and gut microbiota profiling in relation to clinical outcomes such as 30-day mortality, length of hospital stay, readmission and postsepsis sequelae.Ethics and dissemination Verbal and written informed consent will be obtained from all participants or their legal representatives. The study was approved by the Amsterdam University Medical Centre Ethics Committee (No. 2022.0279) and will adhere to the Declaration of Helsinki and the Medical Research Involving Human Subjects Act (WMO). Research results will be published in peer-reviewed journals.Trail registration number ClinicalTrials.gov, NCT06178822.https://bmjopen.bmj.com/content/15/7/e103138.full
spellingShingle Tom van der Poll
W Joost Wiersinga
Michiel Schinkel
Renee A Douma
Hazra S Moeniralam
Marleen A Slim
Evelien Reijnders
Oren Turgman
Sebastiaan C M Joosten
Hessel Peters-Sengers
Towards novel BIOmarkers to diagnose SEPsis (BIOSEP) in the emergency room: a protocol for a multicentre, prospective cohort study
BMJ Open
title Towards novel BIOmarkers to diagnose SEPsis (BIOSEP) in the emergency room: a protocol for a multicentre, prospective cohort study
title_full Towards novel BIOmarkers to diagnose SEPsis (BIOSEP) in the emergency room: a protocol for a multicentre, prospective cohort study
title_fullStr Towards novel BIOmarkers to diagnose SEPsis (BIOSEP) in the emergency room: a protocol for a multicentre, prospective cohort study
title_full_unstemmed Towards novel BIOmarkers to diagnose SEPsis (BIOSEP) in the emergency room: a protocol for a multicentre, prospective cohort study
title_short Towards novel BIOmarkers to diagnose SEPsis (BIOSEP) in the emergency room: a protocol for a multicentre, prospective cohort study
title_sort towards novel biomarkers to diagnose sepsis biosep in the emergency room a protocol for a multicentre prospective cohort study
url https://bmjopen.bmj.com/content/15/7/e103138.full
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