Usefulness of presepsin as diagnostic and prognostic marker of sepsis in daily clinical practice

Abstract

Introduction: Sepsis represents a major cause of morbidity and mortality in critically ill patients. Early diagnosis and appropriate treatment have a crucial influence on survival. The aim of this study was to evaluate the diagnostic and prognostic role of presepsin (sCD14) in patients with sepsis.
 Methodology: Fifty-four consecutive adult patients with sepsis and 26 patients with aseptic meningitis as a control group were included in this prospective observational study. In all patients included in the study, levels of C-reactive protein (CRP), presepsin, lactate, and a count of leukocytes and neutrophils were determined on admission. In those with suspected bacterial infection, two separate blood cultures were obtained and procalcitonin (PCT) concentration was detected. Plasma presepsin and PCT concentrations in septic group patients were followed on days 2, 3 and 7 after enrollment.
 Results: The median presepsin serum concentration in patients with sepsis was 1614 pg/mL and in the control group it was 203 pg/mL (p < 0.001). Presepsin levels in patients with septic shock were higher than in sepsis patients (p < 0.014). The mean presepsin concentrations were higher in deceased than in surviving patients (p = 0.009). The trend of changes in presepsin concentrations in deceased patients was significantly different than in the surviving patients (p = 0.018). There were no statistically significant differences in the concentration of presepsin or other biomarkers in patients with Gram negative or Gram positive bacteria.
 Conclusions: Presepsin may be used as a diagnostic marker of systemic bacterial infection and can predict the severity and outcome of sepsis.

The role of plasma presepsin levels in determining the incidence of septic shock and mortality in patients with sepsis

“…It is a significant cause of mortality worldwide and is an important health problem due to its high mortality rates. The mortality rates vary between 20% and 50% in patients with sepsis and are often > 50% in patients with septic shock [4][5][6][7]. Bacteraemia is detected in only 50%-60% of patients with clinically suspected sepsis [8,9].…”

“…However, immediate initiation of treatment following the early diagnosis of sepsis is associated with a good prognosis [11]. Antimicrobial treatment is generally initiated on the basis of the clinical findings and on detecting a high level of inflammatory markers, such as leukocytes, C-reactive protein (CRP) and procalcitonin (PCT), in the peripheral venous blood [4]. Unfortunately, neither clinical findings nor inflammatory markers are sensitive or specific enough for the diagnosis of sepsis [4].…”

Usefulness of presepsin in predicting the prognosis of patients with sepsis or septic shock: a retrospective cohort study

“…However, in some studies, presepsin levels did not show any significance in predicting mortality [10,16,28]. In other studies, the prognostic value of presepsin was different, and the cutoff value was not clear [7,17,25,30]. It is thought that the non-severe patient groups were not comparable; the differences in the underlying disease and the degree of infection influenced the outcome.…”

Biomarkers of infection in the optimization of antibacterial therapy: justified expectations

“…В настоящее время диагностическая роль пре сепсина в качестве маркера системной бактериальной инфекции ограничивается сепсисом, оценкой тяжести сепсиса и стратификации по группам риска критических пациентов с сепсисом [37][38][39]. Следует отметить, что пресепсин не должен рассматриваться как маркер бак териальной инфекции и не может применяться для тера певтического мониторинга назначенной АБТ, поскольку в настоящее время достоверные исследования и мета анализы, посвященные данным аспектам применения пресепсина отсутствуют.…”