The diagnostic accuracy of presepsin in neonatal sepsis: a meta-analysis

Bellos, Ioannis; Fitrou, Georgia; Pergialiotis, Vasilios; Thomakos, Nikolaos; Perrea, Despina; Daskalakis, Georgios

doi:10.1007/s00431-018-3114-1

Cited by 59 publications

(61 citation statements)

References 38 publications

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“…Montaldo et al [57] findings were recorded for presepsin sensitivity and specificity that were 93% and 100% respectively in the study of early-onset sepsis in newborns and showed better sensitivity and specificity of presepsin than PCT and CRP. Bellos et al [58] reported that Head-to-head comparison with AUC values of C-reactive protein and procalcitonin revealed that presepsin was more sensitive in detecting neonatal sepsis.…”

Section: Discussionmentioning

confidence: 99%

Presepsin as a New Marker for Early Detection Neonatal Sepsis in Al-Quwayiyah General Hospital Riyadh, KSA

Khater

Al-Hosiny

2020

JAMB

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Background: Early detection and start of antibiotic therapy neonatal sepsis (N.S) dramatically improves outcomes, so it is important to perform fast, reliable and specific early laboratory biomarkers. Aim: This study aimed to detect the prevelance, the risk factors, hematology profile, microbial profile of neonatal sepsis patients and also investigate the value of PCT and CRP, in comparison to presepsin in establishing the early diagnosis of neonatal sepsis. Methods: A cross sectional study was performed from March to September 2019 in Al Quwayiyah General hospital involving 120 neonates who were classified into 3 groups. The patients groups Khater and Al-Hosiny; JAMB, 20(1): 80-90, 2020; Article no.JAMB.54569 81 were: Proved N.S, suspected N.S and control healthy neonates, classified depending on Tollner score. Haematology profile and blood culture for each neonate were done. CRP, PCT and presepsin values were analyzed, compared, and their effectiveness as diagnostic markers was determined. Sensitivity, specificity, positive, and negative predictive values of the markers were calculated. Results: The prevelance of neonatal sepsis was 20.8%. 75 neonates were males and 45 neonates were females. 74 neonates were preterm, while 46 were full term. Gestational age in weeks was 31.1±5.9w for neonates with proved sepsis, 32.4±6.7w for neonates with suspected sepsis and 36.4±4.4w for control group. The mean birth weight was 1740±105.3 g for neonates with proved sepsis, 32.4±6.7 g for neonates with suspected sepsis, 2.650±205.2 g for control group. 36 babies suffered from respiratory distress syndrome, 10 had jaundice, 8 had cough, 28 had fever and 8 complained of other symptoms. Blood cultures were positive for all patients of proved sepsis. The identified bacteria included Gram positive bacteria 22(55%) which were Coagulase negative staph. 13(32.5%) followed by Staphylococcus aureus 4(10%) while Gram negative bacteria 15(37.5%) which were E. coli 5(12.5%) followed by Klebsiella peumoniae and also fungal infection (Candida species) detected in 3(7.5%) cases. There was significant difference between the mean and standared deviation of CRP, PCT and presepsin levels in proved and suspected N.S. groups when compared with healthy controls (P< 0.05). CRP sensitivity and specificity (72%, 61% respectively) which were less useful in diagnosis of neonatal sepsis compared to presepsin which has the highest sensitivity and specificity (95%, 81% respectively) followed by procalcitonin with sensitivity and specificity (90%, 69% respectively). Conclusion: The prevalence of neonatal sepsis among all admitted neonates in Al-Quwayiyah general hospital was 20.8%. Our results also detected higher sensitivity, specificity and positive and negative predictive values for presepsin more than and PCT CRP in the diagnosis of NS. Original Research Article

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Section: Discussionmentioning

confidence: 99%

Presepsin as a New Marker for Early Detection Neonatal Sepsis in Al-Quwayiyah General Hospital Riyadh, KSA

Khater

Al-Hosiny

2020

JAMB

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“…The largest study was a meta-analysis conducted by Bellos and co-workers [78]. They identified 11 studies comprising a total number of 783 neonates and calculated a pooled AUC of 0.9751 for the use of presepsin to diagnose sepsis.…”

Section: Neonatesmentioning

confidence: 99%

“…They suggested using 2 to 2.5ng/mL in neonates, as this was proposed by the European Medicines Agency Expert Meeting on Neonatal and Paediatric Sepsis [112], although it was recognised that the available evidence upon which this recommendation was made is controversial. The lack of a pre-specified diagnostic cut-off is also apparent with presepsin, with both the meta-analyses led by Bellos [78] and Kondo [65] in neonatal and adult populations, respectively, limited due to many studies lacking such pre-specified cut-off values, which increases the risk of bias in these studies. In neonatal populations, Bellos and co-workers [78] stratified cut-off values into ≤650, 650 to 850 and ≥850pg/mL, while van Maldeghem and co-workers [82] noted a range of between 305 and 885pg/mL in the studies analysed.…”

Section: Biomarker Diagnostic Cut-off Valuesmentioning

confidence: 99%

“…The lack of a pre-specified diagnostic cut-off is also apparent with presepsin, with both the meta-analyses led by Bellos [78] and Kondo [65] in neonatal and adult populations, respectively, limited due to many studies lacking such pre-specified cut-off values, which increases the risk of bias in these studies. In neonatal populations, Bellos and co-workers [78] stratified cut-off values into ≤650, 650 to 850 and ≥850pg/mL, while van Maldeghem and co-workers [82] noted a range of between 305 and 885pg/mL in the studies analysed. In older children, Yoon and co-workers [85] noted a range of cut-offs from 240 to 1014pg/mL, with higher diagnostic accuracy achieved at values greater than 650pg/mL.…”

Section: Biomarker Diagnostic Cut-off Valuesmentioning

confidence: 99%

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Biomarkers for Point-of-Care Diagnosis of Sepsis

2020

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Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. In 2017, almost 50 million cases of sepsis were recorded worldwide and 11 million sepsis-related deaths were reported. Therefore, sepsis is the focus of intense research to better understand the complexities of sepsis response, particularly the twin underlying concepts of an initial hyper-immune response and a counter-immunological state of immunosuppression triggered by an invading pathogen. Diagnosis of sepsis remains a significant challenge. Prompt diagnosis is essential so that treatment can be instigated as early as possible to ensure the best outcome, as delay in treatment is associated with higher mortality. In order to address this diagnostic problem, use of a panel of biomarkers has been proposed as, due to the complexity of the sepsis response, no single marker is sufficient. This review provides background on the current understanding of sepsis in terms of its epidemiology, the evolution of the definition of sepsis, pathobiology and diagnosis and management. Candidate biomarkers of interest and how current and developing point-of-care testing approaches could be used to measure such biomarkers is discussed.

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“…A recent metaanalysis reported that serum presepsin had greater sensitivity than C-reactive protein and procalcitonin for detection of sepsis [5]. In this issue of the journal, Savić et al [6] studied 60 neonates ≥24 wk of gestation who were intubated and mechanically ventilated on the first day of life.…”

mentioning

confidence: 99%

Can Estimation of Presepsin Levels in Endotracheal Aspirate Predict Early Onset Pneumonia in Newborns?

Awasthi

2018

Indian J Pediatr

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The diagnostic accuracy of presepsin in neonatal sepsis: a meta-analysis

Cited by 59 publications

References 38 publications

Presepsin as a New Marker for Early Detection Neonatal Sepsis in Al-Quwayiyah General Hospital Riyadh, KSA

Presepsin as a New Marker for Early Detection Neonatal Sepsis in Al-Quwayiyah General Hospital Riyadh, KSA

Biomarkers for Point-of-Care Diagnosis of Sepsis

Can Estimation of Presepsin Levels in Endotracheal Aspirate Predict Early Onset Pneumonia in Newborns?

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