Download PDF
Am J Perinatol 2017; 34(06): 550-556
DOI: 10.1055/s-0036-1593851
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Diagnostic Value of Presepsin in Detection of Early-Onset Neonatal Sepsis

Abdurrahman A. Ozdemir
1   Division of Neonatology, Department of Pediatrics, Istanbul Medicine Hospital, Biruni University, Istanbul, Turkey
,
Yusuf Elgormus
2   Department of Pediatrics, Istanbul Medicine Hospital, Biruni University, Istanbul, Turkey
› Author Affiliations
Further Information

Publication History

23 March 2016

20 September 2016

Publication Date:
08 November 2016 (online)

    Permissions and Reprints

Abstract

Objective The aim of this study was to evaluate the efficacy of presepsin in both diagnosis and follow-up of early-onset neonatal sepsis (EOS) and also to compare its effectiveness with C-reactive protein (CRP) and procalcitonin (PCT).

Methods A total of 29 term infants with EOS group and 40 term infants with control group were included in this study. Before initiating therapy, blood samples for whole blood count, CRP, PCT, presepsin, and culture were obtained from all neonates (T0). This procedure was repeated two times at 72 hours (T3) and day 7 (T7).

Results Presepsin levels of sepsis group at T0 were significantly higher (704.27 ± 223.54 pg/mL) than the control group (508.33 ± 165.46 pg/mL). The sensitivity of CRP, PCT, and presepsin at T0 was found to be 83, 67, and 80%, whereas the specificity was found to be 75, 67, and 75%, respectively. The cutoff value for presepsin was 539 pg/mL with an area under the curve of 0.772.

Conclusion Presepsin may be used as a reliable and accurate marker for both diagnosis and follow-up of EOS. However, to increase the accuracy, presepsin may be used in combination with other markers such as CRP and PCT.

Keywords

newborn - early-onset sepsis - presepsin - CRP - procalcitonin
 

  • References

  • 1 Darmstadt GL, Zaidi AKM, Stoll BJ. Neonatal Infections: A global perspective. In: Remington JS, Klein JO, Wilson CB, Nizet V, Maldonado YA, , eds. Infectious Diseases of the Fetus and Newborn Infant. Philadelphia: Elsevier Saunders; 2011: 24-51
    CrossrefGoogle Scholar
  • 2 Polin RA, Parravicini E, Regan JA, Taeusch HW. Bacterial sepsis and meningitis. In: Taeusch HW, Ballard RA, Gleason CA, , eds. Avery's Diseases of the Newborn. Philadelphia, PA: Elsevier Saunders; 2005: 551-577
    CrossrefGoogle Scholar
  • 3 Stronati M, Bollani L, Maragliano R, Ruffinazzi G, Manzoni P, Borghesi A. Neonatal sepsis: new preventive strategies [in Italian]. Minerva Pediatr 2013; 65 (1) 103-110
    PubMedGoogle Scholar
  • 4 Cetinkaya M, Ozkan H, Köksal N, Celebi S, Hacimustafaoğlu M. Comparison of serum amyloid A concentrations with those of C-reactive protein and procalcitonin in diagnosis and follow-up of neonatal sepsis in premature infants. J Perinatol 2009; 29 (3) 225-231
    CrossrefPubMedGoogle Scholar
  • 5 Shah BA, Padbury JF. Neonatal sepsis: an old problem with new insights. Virulence 2014; 5 (1) 170-178
    CrossrefPubMedGoogle Scholar
  • 6 Weinberg GA, D'angio CT. Laboratory aids for diagnosis of neonatal sepsis. In: Remington JS, Klein JO, Wilson CB, Nizet V, Maldonado YA, , eds. Infectious Diseases of the Fetus and Newborn Infant. Philadelphia, PA: Elsevier Saunders; 2011: 1144-1160
    CrossrefGoogle Scholar
  • 7 Köksal N, Harmanci R, Cetinkaya M, Hacimustafaoğlu M. Role of procalcitonin and CRP in diagnosis and follow-up of neonatal sepsis. Turk J Pediatr 2007; 49 (1) 21-29
    PubMedGoogle Scholar
  • 8 Hedegaard SS, Wisborg K, Hvas AM. Diagnostic utility of biomarkers for neonatal sepsis--a systematic review. Infect Dis (Lond) 2015; 47 (3) 117-124
    CrossrefPubMedGoogle Scholar
  • 9 Standage SW, Wong HR. Biomarkers for pediatric sepsis and septic shock. Expert Rev Anti Infect Ther 2011; 9 (1) 71-79
    CrossrefPubMedGoogle Scholar
  • 10 Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest 2003; 111 (12) 1805-1812
    CrossrefPubMedGoogle Scholar
  • 11 Machado JR, Soave DF, da Silva MV , et al. Neonatal sepsis and inflammatory mediators. Mediators Inflamm 2014; ; 2014: 269681. DOI: 10.1155/2014/269681.
    PubMedGoogle Scholar
  • 12 Dupuy AM, Philippart F, Pean Y , et al; Maurice Rapin Institute Biomarkers Group. Role of biomarkers in the management of antibiotic therapy: an expert panel review: I- currently available biomarkers for clinical use in acute infections. Ann Intensive Care 2013; 3 (1) 22
    CrossrefPubMedGoogle Scholar
  • 13 Ramana KV, Pinnelli VB, Kandi S , et al. Presepsin: A novel and potential diagnostic biomarker for sepsis. Am J Med Biol Res 2014; 2: 97-100 . Available at: http://pubs.sciepub.com/ajmbr/2/4/3
    PubMedGoogle Scholar
  • 14 Mussap M, Noto A, Fravega M, Fanos V. Soluble CD14 subtype presepsin (sCD14-ST) and lipopolysaccharide binding protein (LBP) in neonatal sepsis: new clinical and analytical perspectives for two old biomarkers. J Matern Fetal Neonatal Med 2011; 24 (Suppl. 02) 12-14
    PubMedGoogle Scholar
  • 15 Giavarina D, Carta M. Determination of reference interval for presepsin, an early marker for sepsis. Biochem Med (Zagreb) 2015; 25 (1) 64-68
    PubMedGoogle Scholar
  • 16 Endo S, Suzuki Y, Takahashi G , et al. Presepsin as a powerful monitoring tool for the prognosis and treatment of sepsis: a multicenter prospective study. J Infect Chemother 2014; 20 (1) 30-34
    CrossrefPubMedGoogle Scholar
  • 17 Yaegashi Y, Shirakawa K, Sato N , et al. Evaluation of a newly identified soluble CD14 subtype as a marker for sepsis. J Infect Chemother 2005; 11 (5) 234-238
    CrossrefPubMedGoogle Scholar
  • 18 Gitto E, Karbownik M, Reiter RJ , et al. Effects of melatonin treatment in septic newborns. Pediatr Res 2001; 50 (6) 756-760
    CrossrefPubMedGoogle Scholar
  • 19 Manroe BL, Weinberg AG, Rosenfeld CR, Browne R. The neonatal blood count in health and disease. I. Reference values for neutrophilic cells. J Pediatr 1979; 95 (1) 89-98
    CrossrefPubMedGoogle Scholar
  • 20 Rodwell RL, Leslie AL, Tudehope DI. Early diagnosis of neonatal sepsis using a hematologic scoring system. J Pediatr 1988; 112 (5) 761-767
    CrossrefPubMedGoogle Scholar
  • 21 Simonsen KA, Anderson-Berry AL, Delair SF, Davies HD. Early-onset neonatal sepsis. Clin Microbiol Rev 2014; 27 (1) 21-47
    CrossrefPubMedGoogle Scholar
  • 22 Hofer N, Zacharias E, Müller W, Resch B. An update on the use of C-reactive protein in early-onset neonatal sepsis: current insights and new tasks. Neonatology 2012; 102 (1) 25-36
    CrossrefPubMedGoogle Scholar
  • 23 Chiesa C, Panero A, Rossi N , et al. Reliability of procalcitonin concentrations for the diagnosis of sepsis in critically ill neonates. Clin Infect Dis 1998; 26 (3) 664-672
    CrossrefPubMedGoogle Scholar
  • 24 Vouloumanou EK, Plessa E, Karageorgopoulos DE, Mantadakis E, Falagas ME. Serum procalcitonin as a diagnostic marker for neonatal sepsis: a systematic review and meta-analysis. Intensive Care Med 2011; 37 (5) 747-762
    Google Scholar
  • 25 Lapillonne A, Basson E, Monneret G, Bienvenu J, Salle BL. Lack of specificity of procalcitonin for sepsis diagnosis in premature infants. Lancet 1998; 351 (9110): 1211-1212
    CrossrefPubMedGoogle Scholar
  • 26 Bonac B, Derganc M, Wraber B, Hojker S. Interleukin-8 and procalcitonin in early diagnosis of early severe bacterial infection in critically ill neonates. Pflugers Arch 2000; 440 (5, Suppl): R72-R74
    CrossrefPubMedGoogle Scholar
  • 27 Blommendahl J, Janas M, Laine S, Miettinen A, Ashorn P. Comparison of procalcitonin with CRP and differential white blood cell count for diagnosis of culture-proven neonatal sepsis. Scand J Infect Dis 2002; 34 (8) 620-622
    CrossrefPubMedGoogle Scholar
  • 28 Horneff G, Sack U, Kalden JR, Emmrich F, Burmester GR. Reduction of monocyte-macrophage activation markers upon anti-CD4 treatment. Decreased levels of IL-1, IL-6, neopterin and soluble CD14 in patients with rheumatoid arthritis. Clin Exp Immunol 1993; 91 (2) 207-213
    PubMedGoogle Scholar
  • 29 Egerer K, Feist E, Rohr U, Pruss A, Burmester GR, Dörner T. Increased serum soluble CD14, ICAM-1 and E-selectin correlate with disease activity and prognosis in systemic lupus erythematosus. Lupus 2000; 9 (8) 614-621
    CrossrefPubMedGoogle Scholar
  • 30 Bas S, Gauthier BR, Spenato U, Stingelin S, Gabay C. CD14 is an acute-phase protein. J Immunol 2004; 172 (7) 4470-4479
    CrossrefPubMedGoogle Scholar
  • 31 Oesterreicher C, Pfeffel F, Petermann D, Müller C. Increased in vitro production and serum levels of the soluble lipopolysaccharide receptor sCD14 in liver disease. J Hepatol 1995; 23 (4) 396-402
    CrossrefPubMedGoogle Scholar
  • 32 Blanco A, Solis G, Arranz E, Coto GD, Ramos A, Telleria J. Serum levels of CD14 in neonatal sepsis by Gram-positive and Gram-negative bacteria. Acta Paediatr 1996; 85 (6) 728-732
    CrossrefPubMedGoogle Scholar
  • 33 Okamura Y, Yokoi H. Development of a point-of-care assay system for measurement of presepsin (sCD14-ST). Clin Chim Acta 2011; 412 (23-24): 2157-2161
    CrossrefPubMedGoogle Scholar
  • 34 Kweon OJ, Choi JH, Park SK, Park AJ. Usefulness of presepsin (sCD14 subtype) measurements as a new marker for the diagnosis and prediction of disease severity of sepsis in the Korean population. J Crit Care 2014; 29 (6) 965-970
    CrossrefPubMedGoogle Scholar
  • 35 Ulla M, Pizzolato E, Lucchiari M , et al. Diagnostic and prognostic value of presepsin in the management of sepsis in the emergency department: a multicenter prospective study. Crit Care 2013; 17 (4) R168 . Doi: 10.1186/cc12847
    CrossrefPubMedGoogle Scholar
  • 36 Zhang X, Liu D, Liu YN, Wang R, Xie LX. The accuracy of presepsin (sCD14-ST) for the diagnosis of sepsis in adults: a meta-analysis. Crit Care 2015; 19: 323 . Doi: 10.1186/s13054-015-1032-4
    CrossrefPubMedGoogle Scholar
  • 37 Liu B, Chen YX, Yin Q, Zhao YZ, Li CS. Diagnostic value and prognostic evaluation of Presepsin for sepsis in an emergency department. Crit Care 2013; 17 (5) R244 . Doi: 10.1186/cc13070
    CrossrefPubMedGoogle Scholar
  • 38 Casani A, Cocca F, Coletta C , et al. Presepsin values in healthy mature and near-term neonates using a new immunoassay: a preliminary study. In: Selected Abstracts of 8th International Workshop on Neonatology; Cagliari (Italy); October 24–27, 2012. J Pediatr Neonat Individual Med 2012; 1: 152 . Doi: 10.7363/010106
    PubMedGoogle Scholar
  • 39 Pugni L, Pietrasanta C, Milani S , et al. Presepsin (soluble CD14 subtype): Reference ranges of a new sepsis marker in term and preterm neonates ranges of a new sepsis marker in term and preterm neonates. PLoS One 2015; 10 (12) e0146020 . Doi: 10.1371/journal.pone.0146020
    CrossrefPubMedGoogle Scholar
  • 40 Stojewska M, Behrendt J, Szymanska A , et al. Diagnostic value of presepsin (Scd14-St Subtype) evaluation in the detection of severe neonatal infections. Int J Res Stud Biosci 2015; 3: 110-116 . Available at: https://www.arcjournals.org/pdfs/ijrsb/v3-i1/14.pdf
    PubMedGoogle Scholar
  • 41 Mussap M, Puxeddu E, Puddu M , et al. Soluble CD14 subtype (sCD14-ST) presepsin in premature and full term critically ill newborns with sepsis and SIRS. Clin Chim Acta 2015; 451 (Pt A): 65-70
    CrossrefPubMedGoogle Scholar
  • 42 Topcuoglu S, Arslanbuga C, Gursoy T , et al. Role of presepsin in the diagnosis of late-onset neonatal sepsis in preterm infants. J Matern Fetal Neonatal Med 2016; 29 (11) 1834-1839
    PubMedGoogle Scholar
  • 43 Poggi C, Bianconi T, Gozzini E, Generoso M, Dani C. Presepsin for the detection of late-onset sepsis in preterm newborns. Pediatrics 2015; 135 (1) 68-75
    CrossrefPubMedGoogle Scholar