Presepsin as a Novel Diagnostic Marker in Neonatal Septicemia

Osman, Ahmed H.; Awadallah, Mohamed; Tabl, Hala; Abed, Neveen Tawfik; Goudah, Eman Samir Saad

doi:10.12816/0024924

Cited by 14 publications

(29 citation statements)

References 24 publications

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“…This was in agreement with the studies of De Benedetti et al and Dzwonek et al, in which nearly half of the positive blood cultures grew K. pneumonia 20,21. On the contrary, Osman et al demonstrated that the most common isolated organism from septic neonates was coagulase-negative Staphylococci (17.5%) followed by Staphylococcus aureus (12.5%) and K. pneumonia (10%) 22. 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: Discussionsupporting

confidence: 90%

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<p>Utility of presepsin, soluble triggering receptor expressed on myeloid cells-1, and neutrophil CD64 for early detection of neonatal sepsis</p>

Elmadbouly¹,

Sehemawy²,

Eldesoky³

et al. 2019

IDR

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BackgroundNeonatal sepsis (NS) is an important cause of morbidity and mortality among newborns. Its diagnosis depends mainly on blood culture that takes at least 48 hours to give results. Therefore, searching for biomarkers for early diagnosis is of value. We aimed to assess presepsin, soluble triggering receptor expressed on myeloid cells (sTREM-1), and neutrophil CD64 (nCD64) as early diagnostic biomarkers in NS, and to compare them individually and in combination.MethodsThis hospital-based case–control study has been conducted on 60 full-term neonates recruited from the neonatal intensive care unit, Al-Zahraa Hospital, Al-Azhar University, Cairo, Egypt. Thirty infants with sepsis were compared to 30 postnatal age- and sex-matched healthy controls. Studied neonates were evaluated using clinical and laboratory indicators for sepsis. nCD64 was measured by flow cytometry and, serum presepsin and sTREM-1 were measured by ELISA.ResultsPresepsin, sTREM-1, and nCD64 levels were significantly elevated in septic neonates vs control group (P<0.05). The sensitivities of presepsin, sTREM, and nCD64 were 100%, 96.7%, and 86.7%, respectively. Presepsin had the best diagnostic performance in early diagnosis of NS followed by sTREM-1 and nCD64.ConclusionPresepsin and sTREM-1 are promising biomarkers in screening for NS in comparison with nCD64. However, nCD64 is better used in combination with other biomarkers as CRP.

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Section: Discussionsupporting

confidence: 90%

“…However, due to the lack of information about presepsin reference range in neonates, many studies reported different cut-off values 22,25,26. Relatively different cut-off values may be due to the use of different measurement methods.…”

Section: Discussionmentioning

confidence: 99%

<p>Utility of presepsin, soluble triggering receptor expressed on myeloid cells-1, and neutrophil CD64 for early detection of neonatal sepsis</p>

Elmadbouly¹,

Sehemawy²,

Eldesoky³

et al. 2019

IDR

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“…Out of those five articles, one article was not available in full text [24] and two other articles were not eligible for our review (in one article it was unclear whether they investigated EOS or LOS [25] and in one article unusual ranges of sCD14-ST values were used [26]). Therefore out of this review, two articles [27, 28] were found to be appropriate to use in our review and were included afterwards. The literature search is summarized in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…In total 12 studies were included for qualitative synthesis in this systematic review. An overview of the characteristics of these studies is shown in Table 1 [9–13, 27–33]. All included studies were prospective observational studies and studied septic and healthy neonates.…”

Section: Resultsmentioning

confidence: 99%

Soluble CD14 subtype (sCD14-ST) as biomarker in neonatal early-onset sepsis and late-onset sepsis: a systematic review and meta-analysis

2019

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Background Early diagnosis of bacterial sepsis in neonates is hampered by non-specific symptoms and the lack of rapid responding laboratory measures. The biomarker soluble CD14 subtype (sCD14-ST) seems promising in the diagnostic process of neonatal sepsis. In order to evaluate the differences in diagnostic accuracy of sCD14-ST between early onset sepsis (EOS) and late onset sepsis (LOS) we assessed this systematic review and meta-analysis. Results Twelve articles were included in the systematic review and 10 in the meta-analysis. There was a high risk of bias on patient selection, index test and/or flow and timing. The overall quality of the included studies was moderate. At sepsis onset a consequently higher level of sCD14-ST was found in septic neonates compared to healthy controls with significant higher levels in LOS compared to EOS. In the first 24 h after sepsis onset a significant increase in pooled means of plasma sCD14-ST levels was seen in EOS (t(71.6) = 7.3, p < .0001) while this was not seen in LOS or healthy controls. Optimal cut-off values ranged from 305 to 672 ng/l for EOS cases versus healthy controls. The pooled sensitivity was 81% (95%CI: 0.76–0.85), the pooled specificity was 86% (0.81–0.89) with an AUC of 0.9412 (SE 0.1178). In LOS optimal cut-off values ranged from 801 to 885 ng/l with a pooled sensitivity of 81% (0.74–0.86) and a pooled specificity of 100% (0.98–1.00). An AUC and SROC was not estimable in LOS because of the low number of studies. Conclusions sCD14-ST is a promising and rapid-responding diagnostic biomarker for EOS and LOS. The difference in pooled means between EOS and LOS underlines the importance to consider EOS and LOS as two different disease entities, requiring separate analysis in original articles and systematic reviews. Electronic supplementary material The online version of this article (10.1186/s12865-019-0298-8) contains supplementary material, which is available to authorized users.

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“…We determined low cut off levels and weak specificity and PPV in contrast to good sensitivity and high NPV. There are only few existing paediatric studies focused on analysis of presepsin's diagnostic usefulness, mainly in newborns [18,21]. Papers considered febrile episodes in childhood oncology patients reported also inconclusive results [17,20].…”

Section: Discussionmentioning

confidence: 99%

The role of CRP, PCT, IL-6 and presepsin in early diagnosis of bacterial infectious complications in paediatric haemato-oncological patients

Plesko¹,

Suvada²,

Makohusová³

et al. 2016

neo

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Bacterial infection is the most common complication in paediatric oncological patients during cancer treatment. A suitable tool for early prediction of unfavourable course of infection is still needed. We performed a prospective longitudinal observational study to evaluate of the role of serum biomarkers (C-reactive protein, procalcitonin, interleukin-6, presepsin) in the early diagnosis of bacteraemia (gram-negative versus gram-positive) in patients with haematological malignancies. We observed 69 febrile episodes in 33 patients (17 male, 16 female; 1.5-18.9 years, mean 7.31 years, median 5 years). Within this sample, there were 22 cases of positive blood cultures, 16 cases of sepsis, 38 cases of fever with no signs or symptoms of sepsis, and two deaths from infectious complications. All markers tested had good negative predictive value (73% -93%). CRP was characterized by good specificity for registration bacteraemia (96%, 95% CI: 85% -99%), but other results were inconclusive. We identified comparably balanced sensitivity (64% -81%) and specificity (61% -88%) for interleukin-6 and procalcitonin, and we proved their quality to predict positive blood culture and clinical signs of sepsis as well. Patients with gram-negative bacteraemia had significantly elevated levels of PCT and IL-6 in comparison with a group of patients with gram-positive bacteraemia (p = 0.04 for PCT and p = 0.005 for IL-6). Presepsin was characterized by poor specificity (27%, 95% CI: 15% -43%) and positive predictive value (24%, 95% CI: 12 -39%) for predicting bacteraemia, and by better sensitivity (84%, 95% CI: 55% -98%) and specificity (58%, 95% CI: 42% -73%) for predicting clinical signs of sepsis. Key words: C-reactive protein, procalcitonin, interleukin-6, presepsin, fever, sepsisBacterial infection is the most common treatment-related complication in patients with haematological malignancies [1]. Documented mortality associated with paediatric febrile neutropenia is 2% [2]. The potential for early diagnosis of bacteraemia through serum biomarkers has been the subject to extensive research [3]. In 2012 Phillips et al published large meta-analysis of 25 studies exploring 14 different biomarkers in 3,585 episodes of febrile neutropenia. CRP, PCT and IL-6 were subject to quantitative meta-analysis. The bivariate estimates of diagnostic precision of these biomarkers and outcomes were done. Data were available for meta-analysis for CRP for microbiologically or clinically documented infection (results: cut off > 50mg/dl, sensitivity 65%, specificity 73%), for PCT assessing microbiologically or clinically documented infection (results: cut off > 0.2 mg/ml, sensitivity 96%, specificity 85%), for IL-6 reporting microbiologically or clinically documented infection (results: cut off > 235 pg/ml, sensitivity 68%, specificity 94%), and gram-negative bacteraemia (results: cut off > 1000 pg/ml, sensitivity 78%, specificity 96%). Huge inconsistencies and heterogeneity in the studies included in this review were the most important limiting factors [...

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Presepsin as a Novel Diagnostic Marker in Neonatal Septicemia

Cited by 14 publications

References 24 publications

<p>Utility of presepsin, soluble triggering receptor expressed on myeloid cells-1, and neutrophil CD64 for early detection of neonatal sepsis</p>

<p>Utility of presepsin, soluble triggering receptor expressed on myeloid cells-1, and neutrophil CD64 for early detection of neonatal sepsis</p>

Soluble CD14 subtype (sCD14-ST) as biomarker in neonatal early-onset sepsis and late-onset sepsis: a systematic review and meta-analysis

The role of CRP, PCT, IL-6 and presepsin in early diagnosis of bacterial infectious complications in paediatric haemato-oncological patients

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