Presepsin for the detection of early-onset sepsis in preterm newborns

Montaldo, Paolo; Rosso, Roberto; Santantonio, Alfredo; Chello, Giovanni; Giliberti, Paolo

doi:10.1038/pr.2016.217

Cited by 46 publications

(57 citation statements)

References 26 publications

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“…Interpretation of CRP in the diagnosis of EOS may be hindered by several non‐infectious conditions that influence CRP during the first days after birth . In the present study, P‐SEP had better stability than WBC and CRP for 3 days after birth in the non‐sepsis term group …”

Section: Discussionmentioning

confidence: 47%

“…12 In 2017, Montaldo et al evaluated 32 preterm newborns with EOS and compared them with nonsepsis preterm newborns: the AUC for P-SEP was 0.97 and the best cut-off was 788 ng/mL, with sensitivity 93% and specificity 100%. 15 In the present study, P-SEP 795 pg/mL was established as the cut-off, with sensitivity 85% and specificity 89%.…”

Section: Discussionmentioning

confidence: 93%

“…20 In the present study, P-SEP had better stability than WBC and CRP for 3 days after birth in the non-sepsis term group. 15 Procalcitonin appears to be more specific than CRP in bacterial infection. 21,22 In neonatal sepsis, PCT concentration increases after 4 h due to the pro-inflammatory actions of bacterial endotoxins, reaching a peak after 6-8 h; thus, a rise in PCT occurs earlier than a rise in CRP.…”

Section: Discussionmentioning

confidence: 99%

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Presepsin as a predictor of positive blood culture in suspected neonatal sepsis

Miyosawa

Akazawa

Kamiya

et al. 2018

Pediatrics International

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Presepsin as a predictor of positive blood culture in suspected neonatal sepsis

Miyosawa

Akazawa

Kamiya

et al. 2018

Pediatrics International

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“…Sepsis response is a complex process, and currently, it is unlikely that a single ideal biomarker can be utilized in clinical practice. A combination of several sepsis biomarkers may be more effective, and therefore, many studies have been conducted to determine a biomarker, in addition to CRP, that can be used for early diagnosis of sepsis or identification of the severity of sepsis . Automated measurement of the soluble CD14 subtype presepsin (sCD14‐ST) and many biomarkers, such as lipopolysaccharide binding protein, presepsin, resistin, and triggering receptor expressed on myeloid cell‐1, has been shown to be useful in the diagnosis and follow up of sepsis in neonates .…”

Section: Discussionmentioning

confidence: 99%

“…A combination of several sepsis biomarkers may be more effective, and therefore, many studies have been conducted to determine a biomarker, in addition to CRP, that can be used for early diagnosis of sepsis or identification of the severity of sepsis. 13,14 Automated measurement of the soluble CD14 subtype presepsin (sCD14-ST) and many biomarkers, such as lipopolysaccharide binding protein, presepsin, resistin, and triggering receptor expressed on myeloid cell-1, has been shown to be useful in the diagnosis and follow up of sepsis in neonates. [13][14][15][16] However, most of these biomarkers are expensive, and it is not practically possible to utilize them in many NICUs.…”

Section: Discussionmentioning

confidence: 99%

Red cell distribution width as a predictor of late‐onset Gram‐negative sepsis

Doğan

Varal

2020

Pediatrics International

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Background Late‐onset sepsis (LOS) remains an important cause of morbidity and mortality in preterm infants. In this study, our aim was to investigate the red‐cell distribution width (RDW) levels during a LOS episode, and its association with the type of growing microorganism and mortality. Methods Preterm infants with culture‐proven sepsis during their neonatal intensive care unit stay were enrolled. Red‐cell distribution width levels were obtained in the first 4 h of postnatal life and at the onset of the LOS episode, and compared for these time frames. The study cohort was divided into two groups according to the type of the growing microorganism. The RDW levels were then assessed in intra‐ and inter‐group analyses. Results Eighty‐six infants were included in the final analysis. RDW levels were increased in the study cohort after a LOS attack (P < 0.001). Infants with Gram‐negative sepsis showed a significant increase in their RDW levels, but they remained unchanged in infants with Gram‐positive sepsis (P < 0.001 and P = 0.4, respectively). An RDW cut‐off of >19.50% was related with a sensitivity of 87% and a specificity of 81% for predicting late‐onset Gram‐negative sepsis (P < 0.001). Logistic regression analysis showed a positive association of RDW with mortality when adjusted for covariants (adjusted odds ratio: 1.40; 95% confidence interval: 1.02–1.80; P = 0.03). Conclusions Our findings show that RDW levels increased during a LOS episode in preterm infants, which was especially evident in Gram‐negative infections. We believe that these findings may be of importance in the early diagnosis and prognosis of LOS in preterm infants.

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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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Presepsin for the detection of early-onset sepsis in preterm newborns

Abstract: This study shows that P-SEP is significantly higher in preterm infants with EOS compared with uninfected infants.

Cited by 46 publications

References 26 publications

Presepsin as a predictor of positive blood culture in suspected neonatal sepsis

Presepsin as a predictor of positive blood culture in suspected neonatal sepsis

Red cell distribution width as a predictor of late‐onset Gram‐negative sepsis

Presepsin for the Diagnosis of Neonatal Early-Onset Sepsis

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