---

For details of PIRO staging criteria, please check these refs:

1. Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D et al. 2001 SCCM/ESICM/ACCP/ATS/SIS. International Sepsis Definitions Conference. Crit Care Med 2003;31:1250-6

2. Marshall JC, Vincent JL, Fink MP, Cook DJ, Rubenfeld G, Foster D et al. Measures, markers and mediators: towards a staging system for clinical sepsis. A report of the Fifth Toronto Sepsis Roundtable, Toronto, Ontario, Canada, October 25-26, 2000. Crit Care Med 2003;31:1560-7

All said, I am sure one can make a good diagnosis of sepsis from a good history and clinical examination supported by basic investigations in a majority of cases. As mentioned earlier, CRP and PCT do not give anymore info than merely suggesting inflammatory response.

I do agree that for specific management however, pathogen identification is crucial, which in mopst cases is the weakest link...
Hence the need to develop 'point of care testing' systems like traditional ELISAs (2-3 h), Immunoluminometric PCT assays (3 h) and DNA detection by PCR (5-6 h) which provide more rapid results than culture testing (24-48 h).