{
  "abstract": "Circulating calprotectin is a proposed marker of acute innate immune activation, but reported diagnostic and prognostic performance is inconsistent. We assessed circulating calprotectin and S100A8/A9-related biomarkers for diagnosing acute infection and sepsis and stratifying prognosis in adults. We searched biomedical databases and trial registries through July 4, 2026, for adult studies of circulating calprotectin/S100A8/A9 in acute infection or sepsis. Random-effects models pooled diagnostic and reported prognostic areas under the receiver operating characteristic curve (AUC). Threshold-based sensitivity and specificity were analyzed separately using bivariate random-effects models. We used the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess diagnostic risk of bias and evidence certainty. Exploratory subgroup, sensitivity, biomarker-comparison, and combined-model analyses were also performed. Twenty-two reports representing 21 independent cohorts were included. The primary diagnostic meta-analysis yielded a pooled AUC of 0.741 (95% confidence interval [CI], 0.657-0.810). The pooled AUC was 0.703 (95% CI, 0.600-0.789) for sepsis and 0.758 (95% CI, 0.636-0.849) for acute infection or infection-source-related outcomes. In separate threshold-based analyses, pooled sensitivity and specificity were 0.70 (95% CI, 0.46-0.86) and 0.57 (95% CI, 0.55-0.59) for sepsis, and 0.46 (95% CI, 0.09-0.88) and 0.86 (95% CI, 0.60-0.96) for acute infection or infection-source-related outcomes, respectively. For mortality/survival outcomes, pooled sensitivity and specificity were 0.72 (95% CI, 0.65-0.77) and 0.66 (95% CI, 0.53-0.77), respectively, while the pooled reported prognostic AUC was 0.737 (95% CI, 0.688-0.786). Exploratory analyses were directionally stable, but paired biomarker comparisons did not provide definitive evidence of superiority. Certainty was very low for all major outcomes. Circulating calprotectin and S100A8/A9-related biomarkers provide moderate, context-dependent information in adult acute infection and sepsis. They may serve as adjunctive host-response markers, particularly for selected infection/source contrasts, but current evidence does not support stand-alone diagnosis, universal thresholds, or replacement of established biomarkers and clinical assessment. https://www.crd.york.ac.uk/PROSPERO/view/CRD420261441569, identifier CRD420261441569.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, China.",
    "Department of Anesthesiology, Zigong Hospital of Chengdu University of Traditional Chinese Medicine, Zigong, Sichuan, China."
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yin-Sheng Liao"
    },
    {
      "affs": [
        1
      ],
      "name": "Yu-Ping Deng"
    },
    {
      "affs": [
        0
      ],
      "name": "Jian-Li Song"
    },
    {
      "affs": [
        0
      ],
      "name": "Xuan Yu"
    },
    {
      "affs": [
        0
      ],
      "name": "Qiang Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Bin Lu"
    },
    {
      "affs": [
        0
      ],
      "name": "Guan-Yu Chen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bbq0zb55t0rkb.bib",
  "cited_by": 0,
  "doi": "10.3389/fcimb.2026.1934020",
  "fulltext_url": "https://europepmc.org/articles/PMC13713635",
  "id": "bbq0zb55t0rkb",
  "issns": [
    "2235-2988"
  ],
  "landing_url": "https://europepmc.org/article/MED/42952930",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Systematic Review"
    ],
    [
      "openalex",
      "2713|Sepsis Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7221776277",
  "pdf_url": "https://europepmc.org/articles/PMC13713635?pdf=render",
  "pmcid": "PMC13713635",
  "pmid": "42952930",
  "published": "2026-10-14",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/bbq0zb55t0rkb.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:41Z",
      "native_id": "MED:42952930",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42952930"
    },
    {
      "first_seen": "2026-10-31T12:24:09Z",
      "native_id": "PMC13713635",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fcimb.2026.1934020"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Sepsis Diagnosis and Treatment",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Circulating calprotectin and S100A8/A9-related biomarkers for diagnosis and prognostic stratification in adult acute infection and sepsis: a systematic review and meta-analysis.",
  "title_text": "Circulating calprotectin and S100A8/A9-related biomarkers for diagnosis and prognostic stratification in adult acute infection and sepsis: a systematic review and meta-analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:21:16Z",
  "url": "https://research.draconitic.com/paper/bbq0zb55t0rkb",
  "venue": "Frontiers in cellular and infection microbiology",
  "versions": []
}