Perinatal presepsin assessment: a new sepsis diagnostic tool?

Abstract

Perinatal sepsis constitutes a medical emergency and is still one of the major causes of mortality and morbidity. The possibility of an early diagnosis of sepsis is still debated and controversial. In particular, clinical symptoms can be hidden by the association of sepsis with other perinatal diseases and/or by therapeutic strategies performed. In this context, there is evidence that the accuracy of standard of care diagnostic parameters (i.e. blood culture, C-reactive protein, procalcitonin) can be biased by additional confounding factors (gestational age, birth-weight, acute-chronic hypoxia). Therefore, the inclusion in clinical daily practice of new biomarkers of sepsis is of utmost importance. Of a panel of biomarkers, Presepsin (P-SEP) plays an important role in the development and response of the immune system and as an early marker of sepsis both in adult and pediatric patients. Therefore, in the present review we aim to offer an overview of the role of P-SEP in the early detection of perinatal sepsis as a trustworthy marker according to actual statements of official international institutions. Future perspectives regard the possibility of a longitudinal non-invasive biological fluids P-SEP assessment thus limiting the sample stress in high risk newborns.

The role of presepsin in pediatric patients with oncological and hematological diseases experiencing febrile neutropenia

“…Elevated circulating presepsin levels are considered an early indicator of immune system activation, as it increases in the bloodstream 2 h after the onset of the infection 12,14,15 . The role of presepsin has extensively been studied in sepsis in both adult and pediatric patients, revealing it to be an accurate biomarker [16][17][18][19][20][21][22][23] . In detail, presepsin has been shown to be a reliable biomarker for sepsis in children presenting to the Emergency Department with signs of infection and for early-or late-onset sepsis in newborns admitted to the neonatal intensive care unit (NICU) 16,[23][24][25] .…”

Presepsin as a Diagnostic and Prognostic Biomarker in Sepsis

“…Among the biomarkers identified as a potential diagnostic markers for neonatal sepsis, presepsin seems to be promising. A recently published review analyzed literature data about presepsin as a biomarker for the diagnosis of neonatal sepsis [77]. In 2015, 13 studies [78][79][80][81][82][83][84][85][86][87][88][89][90] were assessed presepsin accuracy as an early diagnostic biomarker of sepsis in infants preterm and term infants.…”

Биологические Маркеры Сепсиса

“…При перинатальном сепсисе интерпретация стандартных диагностических показателей, таких как результаты посева крови на стерильность, уровни CRP и PCT, бывает затруднена сопутствующими факторами: гестационным возрастом, массой тела при рождении, гипоксией. В связи с этим включение в повседневную клиническую практику новых биомаркеров сепсиса имеет первостепенное значение [62].…”

“…Это быстро реагирующий на возбудителей бактериальных и грибковых инфекций биомаркер [64]. Пресепсин также играет важную роль в развитии и реакции иммунной системы и используется в качестве раннего маркера сепсиса как у взрослых, так и у детей [62].…”