Presepsin as an Early Predictor of Neonatal Sepsis

Abstract

Background Pathogens stimulate presepsin (P-SEP) shedding from immune cells such as macrophages, monocytes, and neutrophils. Although its function is still unclear, P-SEP is believed to interact with B and T cells to modulate specific immune responses. We aimed to evaluate the accuracy of P-SEP as a novel biomarker for the diagnosis of bacterial infection and correlate its level with blood culture, C-reactive protein (CRP), and procalcitonin (PCT) levels. Materials and Methods: This is a prospective comparative study conducted at Minia University Hospital, Egypt, including eighty neonates. They were divided into two groups: Group I: Twenty full term neonates; infants > 37 weeks. Group II: Sixty preterm neonates Group II A: 20 Low birth weight neonates: 1501- 2500 gr, Group IIB: 20 Very low birth weight neonates: 1001-1500 gr, Group II C: 20 Extremely low birth weight neonates: 500-1000 gr. Cord presepsin (presepsin 1) was measured at birth. CBC, CRP, Blood culture, Procalcitonin and presepsin 2 were measured after the onset of sepsis. Results: No significant difference in levels of P-SEP 1 was found between the two groups.P-SEP 2 levels were higher in sepsis group than in non-sepsis group. Presepsin showed more diagnostic accuracy than PCT in diagnosis of sepsis. The best cut-off value for Presepsin was 485 pg/ml, with 97.8% sensitivity, and 94.1% specificity. Conclusion Presepsin as a biomarker is not only suitable for early diagnosis of sepsis but it is also more accurate than both PCT and CRP.