Presepsin as a diagnostic biomarker of peri-prosthetic joint infection: a review of the literature

Delva, Mona L.; Samuel, Linsen T.; Acuña, Alexander J.; Kamath, Atul F.

doi:10.1007/s00590-022-03232-z

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…A significant threshold variation persists across studies. Although presepsin is recognized as an indicator of sepsis, recent studies have been published exploring its relationship with infectious diseases [39][40][41][42][43][44][45]. The defined cutoff value of 600 pg/mL was established for bacterial infectious diseases [36].…”

Section: Discussionmentioning

confidence: 99%

The Potential Role of Presepsin in Predicting Severe Infection in Patients with Diabetic Foot Ulcers

Ha,

Park,

Chung

et al. 2024

JCM

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Background/Objectives: Diabetic foot ulcers are one of the complications in patients with diabetes, which can be caused by infection, neuropathy, and blood vessel disorder. Among them, infection is the most common cause, and if it becomes worse, amputation may be necessary. So, it is important to detect and treat infections early, and determining indicators that can confirm infection is also important. Known infection markers include white blood cells (WBCs), the erythrocyte sediment rate (ESR), C-reactive protein (CRP), and procalcitonin, but they are not specific to diabetic foot ulcers. Presepsin, also known as soluble CD14, is known to be an early indicator of sepsis. Recent studies have reported that presepsin can be used as an early indicator of infection. This study investigated whether presepsin could be used as an early marker of severe infection in patients with diabetic foot ulcers. Methods: We retrospectively studied 73 patients who were treated for diabetic foot ulcerations from January 2021 to June 2023 at Yeungnam University Hospital. Results: Out of a total of 73 patients, 46 patients underwent amputations with severe infections, and the WBC level, ESR, and CRP, procalcitonin, and presepsin levels were significantly higher in the group of patients who underwent amputations. The cutoff of presepsin, which can predict serious infections that need amputation, was 675 ng/mL. A regression analysis confirmed that presepsin, HbA1c, and osteomyelitis significantly increased the risk of severe infections requiring amputation. Conclusions: Presepsin will be available as an early predictor of patients with severe infections requiring amputations for diabetic foot ulcerations.

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Section: Discussionmentioning

confidence: 99%

The Potential Role of Presepsin in Predicting Severe Infection in Patients with Diabetic Foot Ulcers

Ha,

Park,

Chung

et al. 2024

JCM

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“…A threshold for the synovial absolute neutrophil count of 2,247 cells/mL showed an AUC of 0.905 for a diagnosis of chronic hip PJI. In a literature review of serum presepsin in PJI 24 , studies demonstrated AUC values ranging from 0.86 to 0.926. These values were higher than the AUCs for CRP in each of their respective studies, yet further study is needed to explore this emerging biomarker.…”

Section: Diagnosismentioning

confidence: 99%

What’s New in Musculoskeletal Infection

Otero,

Dombrowski,

Brown

et al. 2024

Journal of Bone and Joint Surgery

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Periprosthetic joint infection (PJI) continues to be a devastating complication after total joint arthroplasty (TJA) and remains one of the most common causes for revision TJA. Projections are clear that primary TJA will continue to increase annually and, with it, PJI. In 2022, there was an emphasis on the global economics of PJI management, whereas, in 2023, the literature attempted to provide a more granular look at the financial burden of PJI. Wixted et al. analyzed the direct costs of PJI at a tertiary referral center, including the costs of relevant ancillary services, and demonstrated that the failure of successful reimplantation and the need for additional surgical procedures more than doubled the direct costs of PJI management ($38,865 compared with $79,223) 1 . Additionally, Charalambous et al. assessed cost drivers of 2-stage exchange for PJI treatment and found that age, illicit drug use, the Elixhauser comorbidity index, and number of surgical procedures before reimplantation were all associated with an increased cost of PJI treatment and that failure to clear infection was associated with a >50% increase in total costs at 2 years after treatment 2 . In 2023, the psychosocial impact of PJI was also highlighted. Shichman et al. demonstrated that the sequelae of PJI decreased patientreported quality of life, social satisfaction, and mental health, with approximately 1 of 4 patients regretting their initial decision to undergo primary TJA 3 . Das et al. demonstrated that patients who underwent spacer placement for PJI after TJA had a disproportionately higher incidence of mental health disorders following a surgical procedure compared with aseptic revisions and primary TJA, urging surgeons to consider collaborative management with mental health professionals in the treatment of PJI 4 .Not only are mental health disorders a consequence of PJI, but they are also likely a risk factor. Harmer et al. demonstrated that depression and anxiety were associated with an increased risk of any infection, and specifically with an increased risk of PJI after revision total knee arthroplasty (TKA) 5 .Two-stage exchange continues to be considered the mainstay treatment of PJI, although 1-stage treatment is gaining popularity. In an Australian cost-utility analysis using a Markov model, Okafor et al. found that opting for an index 2-stage revision instead of a 1-stage revision when there is no compelling indication for 2-stage exchange is not likely to be cost-effective 6 . In the United States, most surgeons are utilizing 2-stage exchange, with 75% of American Association of Hip and Knee Surgeons (AAHKS) survey respondents reporting the use of 2-stage exchange rather than 1-stage exchange and with the majority of surgeons handling <20 PJI cases per year 7 . Despite this, the use of single-stage exchange is increasing across the globe, with a single high-volume European center reporting a >30% increase in 1-stage exchange from 2008 to 2021 8 . Fehring et al. reported a 99% reimplantation rate after 2-stage exchange at the...

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The diagnostic utility of HBP, CRP, and ESR in patients undergoing joint replacement surgery for periprosthetic joint infections

Zhou,

Zhang,

Zhang

et al. 2024

Asian Journal of Surgery

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Presepsin as a diagnostic biomarker of peri-prosthetic joint infection: a review of the literature

Cited by 4 publications

References 29 publications

The Potential Role of Presepsin in Predicting Severe Infection in Patients with Diabetic Foot Ulcers

The Potential Role of Presepsin in Predicting Severe Infection in Patients with Diabetic Foot Ulcers

What’s New in Musculoskeletal Infection

The diagnostic utility of HBP, CRP, and ESR in patients undergoing joint replacement surgery for periprosthetic joint infections

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