Presepsin as diagnostic test in neonatal sepsis

Abstract

Background: Sepsis is clinical syndrome characterized by hemodynamic, respiratory and metabolic changes resulting from infectious processes that trigger systemic inflammatory response syndrome. The latest diagnosis enforcement of neonatal sepsis in the form of biomarker, presepsin. This research was established to estimate the accuracy of presepsin in diagnosing neonatal sepsis in preterm Methods: This study is cross-sectional study with diagnostic test design to determine the accuracy of presepsin examination in diagnosing neonatal sepsis with gold standard used double-sided blood culture. Sample size was 62 samples. Data analysis including sensitivity, specificity, positive predictive value, negative predictive value and accuracy of presepsin as diagnostic test calculated by using 2x2 table. Results: This study involved 62 subjects. Subjects were dominated by median age 3, male 66.1%, birth weight 1500-<2500 grams 53.2%, vigorous baby 51.6%, caesarean section 67.7%, median leukocytes 4.8, median platelets 101.4, median IT-ratio 0.33, procalcitonin 2.21 and positive blood culture 77.4%. The AUC value is 85% and ROC curve showed 2 cut off values, namely 150 pg/mL, 44 subjects suffer neonatal sepsis with sensitivity 91.7%, specificity 78.57%, positive predictive value 93.62%, negative predictive value 73.3%, positive trend ratio 4.28, prevalence 77% and accuracy 88.71%. Cut off 243 pg/mL sensitivity 75%, specificity 85.7%, positive predictive value 94.6%, negative predictive value 50.6%, positive trend ratio 5.25, prevalence 77% and accuracy 77.46%. Conclusion: A cut off value 150 pg/mL, sensitivity 91.67% presepsin can be used as screening tool and cut off 243 pg/mL with specificity 85.7% as high specificity diagnostic test.