Diagnostic Evaluation of Modified Hematological Sepsis Score and Presepsin in Neonatal Sepsis

Abstract

Abstract Background Early diagnosis of neonatal sepsis and assessment of the severity of the disease is not yet effectively achieved. Some hematological parameters are used to formulate a hematological scoring system (HSS) and a modified hematological scoring system(MHSS), for diagnosis of neonatal sepsis. A promising biomarker is Presepsin, or Soluble Cluster of Differentiation 14 SubType (sCD14-ST), which is a proteolysis product of CD14, that is produced after immune activation during infections. Aim of the Work To evaluate the performance of both HSS, MHSS and serum presepsin level, in neonatal sepsis, and compare them to C-reactive protein (CRP) as diagnostic tools and predictors of mortality. Methods The study was divided into two groups, one group comprised 51 neonates who further subgrouped into suspected & proved sepsis, along with 30 neonates who were admitted for non-infectious causes who served as control group. Both groups were subjected to calculation of HSS, MHSS, serum presepsin levels, CRP measurement, blood culture and, assessed for clinical severity and mortality. Results Hematological sepsis scores and presepsin levels were significantly higher in sepsis group. Presepsin showed the best diagnostic performance at > 0.5 ng/ml (AUC 0.979; sensitivity of 94.1% and specificity of 100%). While HSS and MHSS at a cutoff value > 1 achieved comparable specificity but lower sensitivity, 72.6% for the former and 76.5% for the later. Presepsin also was significantly higher in died group with the best predictive performance over CRP at cut-off value >1.9 ng/ml (AUC 0.83; sensitivity of 85.7% and specificity of 79.6%) Conclusions Hematological sepsis scores and presepsin were found to be useful diagnostic tools in neonatal sepsis with presepsin as a good predictor of mortality comparable to CRP. Disclosure: The authors declare that they have no conflict of interest.