Presepsin as an Early Predictor of Neonatal Sepsis

Background Pathogens stimulate presepsin (P-SEP) shedding from immune cells such as macrophages, monocytes, and neutrophils.  Although its function is still unclear, P-SEP is believed to interact with B and T cells to modulate specific immune responses. We aimed to evaluate the accuracy of P-SEP as a novel biomarker for the diagnosis of bacterial infection and correlate its level with blood culture, C-reactive protein (CRP), and procalcitonin (PCT) levels. Materials and Methods: This is a prospective comparative study conducted at Minia University Hospital, Egypt, including eighty neonates. They were divided into two groups: Group I: Twenty full term neonates; infants > ۳۷ weeks. Group II: Sixty preterm neonates Group II A: ۲۰ Low birth weight neonates: ۱۵۰۱- ۲۵۰۰ gr, Group IIB: ۲۰ Very low birth weight neonates: ۱۰۰۱-۱۵۰۰ gr, Group II C: ۲۰ Extremely low birth weight neonates: ۵۰۰-۱۰۰۰ gr. Cord presepsin (presepsin ۱) was measured at birth. CBC, CRP, Blood culture, Procalcitonin and presepsin ۲ were measured after the onset of sepsis. Results: No significant difference in levels of P-SEP ۱ was found between the two groups.P-SEP ۲ levels were higher in sepsis group than in non-sepsis group. Presepsin showed more diagnostic accuracy than PCT in diagnosis of sepsis. The best cut-off value for Presepsin was ۴۸۵ pg/ml, with ۹۷.۸% sensitivity, and ۹۴.۱% specificity. Conclusion Presepsin as a biomarker is not only suitable for early diagnosis of sepsis but it is also more accurate than both PCT and CRP.   

کلیدواژه ها:

prespsin ، Procalcitonin ، Sepsis ، Neonates