&lt;p&gt;Utility of presepsin, soluble triggering receptor expressed on myeloid cells-1, and neutrophil CD64 for early detection of neonatal sepsis&lt;/p&gt;

Elmadbouly, Asmaa A.; Sehemawy, Asmaa A El; Eldesoky, Noha Abdel-Rahman; Elgalil, Heba Mohammed Abd; Ahmed, Amal Mokhtar

doi:10.2147/idr.s191533

Cited by 23 publications

(32 citation statements)

References 34 publications

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“…Within the sepsis group, EOS was higher (51.64%) than LOS (48.35%). This observation was constant with previous studies [12,27].…”

Section: Discussionsupporting

confidence: 92%

“…In the current study, the NICU mortality rate from neonatal septicemia was as high as 33% which comes in line with other studies results [12,15,26]. This study included 91 clinically septic neonates and 30 control neonates.…”

Section: Discussionsupporting

confidence: 88%

“…On the contrary, El-Madbouly et al [12] reported that K. pneumonia was the most frequent isolated organism from the blood of sepsis neonates (44.4%) which agreed with other studies [33]. This difference may be attributed to variation in local epidemiology and the microbial etiology of sepsis in addition to different care practices between medical centers.…”

Section: Biomed Research Internationalsupporting

confidence: 61%

“…The best cutoff of nCD64 was achieved at 43%; this cutoff is variable between the different researches including that of El Shimi et al [35] who reported the best cutoff is 34.1%. These variations between the studies could be attributed to the difference in the number of the study population and the variation in their demographic and clinical characteristics in addition to the different used CD64 expression units [10,12].…”

Section: Biomed Research Internationalmentioning

confidence: 99%

“…Therefore, a more sensitive and specific diagnostic and prognostic tool is highly needed. Several hematologic markers have been investigated alone and in combination with other clinical and laboratory data with varying results [12,13].…”

Section: Introductionmentioning

confidence: 99%

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Valuable Role of Neutrophil CD64 and Highly Sensitive CRP Biomarkers for Diagnostic, Monitoring, and Prognostic Evaluations of Sepsis Patients in Neonatal ICUs

Hashem

Masry

Mokhtar

et al. 2020

BioMed Research International

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Background. Neonatal sepsis (NS) is a very critical medical situation associated with high morbidities and mortalities. There is an utmost need for a new tool helping in early diagnosis and proper management of sepsis neonates. Neutrophil CD64 (nCD64) shows a very promising value in this concerning issue. Aim. Evaluate the diagnostic, monitoring, and prognostic performances of nCD64 and highly sensitive CRP (hs-CRP) in NS as well as the possible best panel of biomarkers that can achieve the most desirable results. Methods. Patients were enrolled from three neonatal intensive care units (NICUs) (n=121 patients) and classified according to their initial sepsis evaluation into three groups: disease control group (n=30), proven sepsis group (n=17), and clinical sepsis group (n=74). Laboratory evaluation included hs-CRP, complete blood count (CBC), and blood culture in addition to nCD64 (done by flow cytometry technique). Besides the diagnostic evaluations, follow-up evaluations were done for 40 patients after five days from the first time; patients were reclassified according to their outcome into the improved sepsis neonates’ group (n=26) and sepsis neonates without improvement (n=14). Results. Significant increase in nCD64 and hs-CRP results were present in sepsis groups compared to the disease controls (P<0.001); nCD64 at 43% cutoff value could detect the presence of sepsis with 85.6% sensitivity and 93% specificity. Additionally, delta change percentage (dC%) between improved sepsis neonates and sepsis neonates without improvement showed a significant difference in the levels of both nCD64 (P<0.001) and hs-CRP (P=0.001). Conclusion. Besides the promising diagnostic performance documented by nCD64 which is higher than the other laboratory sepsis biomarkers used routinely in NICUs, nCD64 has a valuable role in sepsis patients’ monitoring and prognostic evaluation. hs-CRP was moderate in its diagnostic and monitoring results being less than that achieved by nCD64. Combined measurement of nCD64% and hs-CRP gives better diagnostic and monitoring performance than that achieved by any of them alone.

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“…Within the sepsis group, EOS was higher (51.64%) than LOS (48.35%). This observation was constant with previous studies [12,27].…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 88%

Section: Biomed Research Internationalsupporting

confidence: 61%

Section: Biomed Research Internationalmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Valuable Role of Neutrophil CD64 and Highly Sensitive CRP Biomarkers for Diagnostic, Monitoring, and Prognostic Evaluations of Sepsis Patients in Neonatal ICUs

Hashem

Masry

Mokhtar

et al. 2020

BioMed Research International

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Presepsin for the Diagnosis of Neonatal Early-Onset Sepsis

et al. 2022

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IMPORTANCENeonatal early-onset sepsis (EOS) is a severe disease, particularly in preterm infants. Timely diagnosis can be challenging owing to unspecific presentation and questionable performance of the common markers of infection. Presepsin was recently proven to be a promising biomarker for the diagnosis of EOS. OBJECTIVE To assess presepsin accuracy for the diagnosis of EOS.DATA SOURCES PubMed Medline, EMBASE, Web of Science, and Google Scholar. No publication date restrictions were applied. The literature search was limited to the English language. Articles were checked for duplication.STUDY SELECTION Inclusion criteria were studies that (1) included term or preterm newborns (defined as newborns with gestational age Ն37 weeks or <37 weeks, respectively); (2) included a diagnosis of EOS, defined as culture-proven sepsis for primary analysis and as either clinical or culture-proven sepsis for secondary analysis; and (3) assessed presepsin values during the initial workup for suspected EOS. Exclusion criteria were studies that (1) did not include EOS cases; (2) lacked data on presepsin sensitivity and/or specificity; and (3) were case reports, commentaries, or reviews. Two independent reviewers performed the study selection.DATA EXTRACTION AND SYNTHESIS Two independent reviewers performed data extraction and quality assessment. Quality assessment was performed using the Quality Assessment for Studies of Diagnostic Accuracy 2 tool, and data were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURESThe outcomes of interest for both the primary and secondary analyses were presepsin sensitivity, specificity, and diagnostic odds ratio for the diagnosis of EOS. RESULTS A total of 12 studies of 245 (4.9%) met inclusion criteria for the primary analysis. Twenty-three studies of 245 (9.4%) met the inclusion criteria for the secondary analysis. In the primary analysis, among 12 studies and 828 newborns of any gestational age, pooled sensitivity and specificity were 0.93 (95% CI, 0.86-0.95) and 0.91 (95% CI, 0.85-0.95), respectively; pooled diagnostic odds ratio was 131.69 (95% CI,. Subgroup analysis showed that presepsin specificity was associated with the inclusion of only EOS or all neonatal sepsis. Presepsin accuracy was not associated with gestational age, measurement with chemiluminescence enzyme immunoassay or enzyme-linked immunosorbent assay testing, country where the study was performed, or risk of bias judgment. In the secondary analysis, among 23 studies and 1866 newborns, accuracy was significantly associated with only test type. CONCLUSIONS AND RELEVANCEResults of this systematic review and meta-analysis suggest that presepsin was an accurate biomarker of EOS. Clinical trials are warranted to assess its usefulness and safety to reduce early antibiotic exposure, particularly in preterm newborns.

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