Abstract
Sepsis causes high rates of morbidity and mortality in NICUs. The estimated incidence varies between 5 and 170 per 1000 births, depending on the social context. In very low birth-weight neonates, the level of mortality increases with the duration of hospitalization, reaching 36% among infants aged 8–14 days and 52% among infants aged 15–28 days. Early diagnosis is the only tool to improve the poor prognosis of neonatal sepsis. Blood culture, the gold standard for diagnosis, is time-consuming and poorly sensitive. C-reactive protein and procalcitonin, currently used as sepsis biomarkers, are influenced by several maternal and fetal pro-inflammatory conditions in the perinatal age. Presepsin is the N-terminal fragment of soluble CD14 subtype (sCD14-ST): it is released in the bloodstream by monocytes and macrophages, in response to bacterial invasion. Presepsin seems to be a new, promising biomarker for the early diagnosis of sepsis in neonates as it is not modified by perinatal confounding inflammatory factors. The aim of the present review is to collect current knowledge about the role of presepsin in critically ill neonates.
Highlights
Sepsis causes high rates of morbidity and mortality in Neonatal Intensive Care Units (NICUs)
Twenty-one full-text articles were eventually included in a qualitative synthesis of current knowledge of P-SEP levels in neonates: three studies on the reference ranges in neonatal age [4,14,15], four studies on the diagnosis of early-onset sepsis (EOS) [10,16,17,18], four studies on the diagnosis of late-onset sepsis (LOS) [1,19,20,21] and ten studies on the diagnosis of neonatal sepsis in general (EOS and LOS considered together) [22,23,24,25,26,27,28,29,30,31]
P-SEP levels are higher in preterm than in at-term neonates
Summary
Sepsis causes high rates of morbidity and mortality in Neonatal Intensive Care Units (NICUs). The early diagnosis of sepsis in neonates can be a challenge because of its unspecific clinical presentation, the low sensitivity of blood culture, and the poor performance of the currently used markers of infection during the first days of life [4]. Emerging multidrug-resistant (MDR) pathogens emphasize the urgent need to reduce antibiotics use and control their further spread [9]. For these reasons, the development of a rapid and accurate diagnostic test with a strong negative predictive value of sepsis is crucial to reduce abuse of antibiotics in neonates [10]. The ideal marker for infection should be valuable for establishing the diagnosis, as well as for predicting the outcome and for evaluation of the response to treatment; concomitantly, it should be easy to quantify and available for routine clinical use [11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
