Diagnostic Value Of Presepsin Research Articles

Diagnostic value of presepsin in odontogenic infection: a retrospective study

BackgroundMost head and neck infections originate from odontogenic causes; therefore, it is important to determine the severity of odontogenic infections. Since severe infection can cause sepsis, a systemic examination should be performed when evaluating a patient with odontogenic infection. C-reactive protein (CRP), white blood cell count (WBC), procalcitonin (PCT), and presepsin (PSEP) can be used to evaluate the severity of inflammatory status and sepsis in patients in the early stages of visiting the emergency room. Moreover, sepsis can be diagnosed based on the systemic inflammatory response syndrome (SIRS) classification. In relation to PSEP, significant study results on sepsis have been reported in other organ infections. However, there has been no progress in odontogenic infection; therefore, this study aimed to determine the diagnostic value of sepsis derived from odontogenic infection.MethodsThis study was conducted from March 2021 to October 2021 on 43 patients admitted to the Department of Oral and Maxillofacial Surgery, Dankook University Hospital, in the emergency room for odontogenic infection. All patients underwent vital sign assessment and diagnostic tests (CRP, WBC, PCT, PSEP) in the emergency room. Sepsis was classified according to the SIRS criteria, and CRP, WBC, PCT, and PSEP levels were measured. The Statistical Package for the Social Sciences was used for statistical analyses.ResultsThe results of this study showed a moderately positive correlation between CRP and PCT, CRP and PSEP, and CT and PSEP levels. In addition, PCT and PSEP levels showed a positive correlation with sepsis. The odds ratios of sepsis and PCT and sepsis and PSEP were statistically significant. The optimal cut-off values obtained through the receiver operating characteristic curve were 0.24 and 671.5 for PCT and PSEP, respectively. Finally, there were positive correlations between CRP level and length of stay, WBC and Flynn scores, PCT level and Flynn scores, PCT level and length of stay, and PSEP level and length of stay.ConclusionWBC and CRP and PCT levels have been used in the past to determine the severity of infection and sepsis in patients with odontogenic infection, but PSEP was also found to have diagnostic value in this study. According to this study, a PSEP level of 671.5 pg/ml or higher for odontogenic infection can be considered an abnormal level.

Usefulness of presepsin for the early detection of infectious complications after elective colorectal surgery, compared with C-reactive protein and procalcitonin

Infectious complications remain a major clinical problem in colorectal surgery. Presepsin has been reported to be a useful marker to diagnose sepsis, similar or superior to procalcitonin (PCT) and C-reactive protein (CRP). The aim of this study was to assess the diagnostic value of presepsin in the early detection of infectious complications after elective colorectal surgery, compared with CRP and PCT. This study was a prospective observational study. Patients of age > 18 who underwent elective colon resections were enrolled. Blood samples were collected just before surgery and on postoperative day (POD) 1, 2, 3, 4, and 6 to measure plasma levels of biomarkers. We evaluated the association between circulating biomarkers and infections. A total of 114 patients were examined, and 27 patients (23.7%) developed infectious complications. CRP and PCT markedly increased from POD 1 to POD 3 and then gradually decreased toward POD 6 in both groups, but the trends of the decrease in the infected group were blunt, compared with those in the non-infected group. On the other hand, presepsin did not show major changes just after surgery, but it increased on POD 4 and POD 6, when the complications occurred. Monitoring the presepsin trends after colorectal surgeries could be helpful to detect postoperative infectious complications.Trial registration: UMIN000025313. Registered on 17 December 2016.

Could presepsin be an alternative marker in the early diagnosis of sepsis in COVID-19?

In critical patients with Coronavirus Disease (COVID-19), we investigated the diagnostic value of presepsin in the early diagnosis of superinfection with sepsis, and the effect of antibiotic treatment (AT) in the levels of presepsin and procalcitonin and C-reactive protein. A total of 68 critical patients with sepsis and septic shock in the intensive care unit and 20 outpatients (control group) with COVID-19 were taken. ICU patients (n = 68) were further divided into three groups. C(−)AT(−) had negative blood or tracheal aspirate cultures (C) and not AT on admission to ICU (n = 18), C(−)AT(+) had negative C and AT on admission to intensive care unit (n = 31) and C(+) had positive C (n = 19). Presepsin, procalcitonin, C-reactive protein results were compared between the groups. There were no significant relationships between presepsin levels with sepsis, septic shock, mortality, or length of stay in ICU in patients with COVID-19. For procalcitonin and C-reactive protein levels in C(−)AT(+) and C(+) groups were significantly higher than in control and C(−)AT(−) groups (p < .001). C-reactive protein levels in C(−)AT(−) group were significantly higher than in the control group (p < .001). PCT and CRP, there was no difference between C(−)AT(+) and C(+) groups, and procalcitonin there was no difference between control and C(−)AT(−) groups. Presepsin was not found as a useful biomarker for the prediction of sepsis in COVID-19 patients. These study findings indicate that procalcitonin and C-reactive protein may be an indicator of an early diagnostic marker for superinfection in critical COVID-19 patients.

The Diagnostic Value of Presepsin in Acute Appendicitis and Reference Ranges for Healthy Children.

This study aimed to investigate the diagnostic value of presepsin, a new inflammatory marker for paediatric appendicitis, and to determine a reference range of presepsin for children. This single-center prospective study was conducted in our paediatric emergency department between 1 February 2021 and 1 July 2021. Patients aged 0-18 years diagnosed with acute appendicitis, which was pathologically confirmed, and healthy volunteers in the same age group were included in the study. Serum presepsin levels were analysed using an enzyme-linked immunosorbent assay reader. In addition to presepsin, other acute-phase reactants, paediatric appendicitis scores and imaging methods were evaluated. There were 94 patients in the acute appendicitis group and 102 healthy volunteers in the control group. Median values were compared between the two groups, and no statistically significant differences were found (p = 0.544). In addition, no statistically signivficant differences in presepsin levels were found between the acute and perforated appendicitis groups (p = 0.344). The median (IQ1-IQ3) reference range for presepsin in healthy children was 0.9950 (0.7575-1.610) ng/mL. Presepsin is not a suitable marker for the diagnosis of acute appendicitis. We observed that serum presepsin levels were not elevated in paediatric appendicitis, which is a local infection, in contrast to previous studies.

The diagnostic value of presepsin as a marker for congenital infections in newborns

The identification of the earliest diagnostic markers for infections in newborns remains one of the priorities in neonatology. In our study, we aimed to assess the diagnostic value of presepsin (P-SEP) as a marker for congenital infections in newborn children. The study was prospective in design and took place from January 2020 to February 2021. We enrolled a total of 64 children with a gestational age of 24 to 40 weeks. The study was approved by the Biomedical Research Ethics Committee (Minutes No.12 of 17 November 2016) and the Scientific Council (Minutes No.19 of 29 November 2016) of the V.I. Kulakov NMRC OGP of Ministry of Healthcare of the Russian Federation. Written voluntary consent to the patients’ participation in the study was obtained from their legal representatives. The patients were divided into 2 groups: a group of interest consisting of newborn children with congenital infections (n = 30), and a control group comprising newborns without signs of infection (n = 34). The group of interest included children with congenital pneumonia (n = 25), urinary tract infections (n = 3), and infections specific to the perinatal period, without a focus of infection (n = 2). Gestational age and birth weight were comparable between the groups. No statistically significant differences in CRP levels, neutrophil counts, immature-to-total neutrophil ratios and lactate concentrations on days 1 and 3 of life were found between the two groups. In the group of interest, P-SEP on day 1 of life was significantly higher than in the control group (р = 0.015). Our findings suggested that P-SEP levels ≥ 481 pg/mL could predict a high risk of congenital infections in newborns. The sensitivity and specificity were 91.0% and 60.0% respectively. P-SEP levels determined in capillary blood were similar to those obtained from venous blood samples suggesting that either can be used for P-SEP measurement with equal success. P-SEP levels were shown to decrease by day 3 of life in the children with congenital infections who had been treated with antibiotics.

Diagnostic Value of Presepsin among Infected Adults in The Intensive Care Unit

Background: Infection is a challenge in intensive care units (ICUs), causing high mortality and morbidity. Early diagnosis and prediction is useful in improving management strategies of Adult patients. This study aimed at assessing the accuracy of presepsin for diagnosis of sepsis among adults.Methods: This study was conducted on ninety-six patents within ICUs of Internal Medicine hospital Zagazig University from December 2019 and May 2020. All patients were assessed physically with quick SOFA score, laboratory investigations including serum presepsin level. Results: Age of patients ranged from 19 to 60 years with median 56.5 years and male represented 54.2%. Positive blood culture was found in 75% of patients; out of them, 66.7%, 22.2% and 11.1% had infection, sepsis and septic shock respectively. About 57% and 24% had pneumonia and urinary tract infection respectively. Median C reactive protein (CRP) and procalcitonin were 62.5% and 1.7% respectively. Presepsin significantly positively correlated with procalcitonin and C reactive protein (p < 0.05). It significantly negatively correlated with platelet count (p < 0.05). There is significant association between serum presepsin and disease severity, with highest level in septic shock followed by sepsis (p < 0.05). The best cutoff of serum presepsin in diagnosis of infection was ≥1.95 mg/mL with sensitivity 80% and specificity 71% while at cutoff ≥2.4 mg/mL, it can predict sepsis, sensitivity 78.3% and specificity 69%. Presepsin cutoff ≥7.9 mg/mL can predict septic shock with sensitivity 90% and specificity 92%.Conclusion: Presepsin is a promising marker for diagnosis of infection and sepsis with capability for differentiating between sepsis severity groups.

Diagnostic Value of Presepsin in Elderly Patients with COPD Exacerbation

Diagnostic Value of Presepsin in Elderly Patients with COPD Exacerbation

Diagnostic Value of Presepsin in Detection of Early-Onset Neonatal Sepsis.

Objective The aim of this study was to evaluate the efficacy of presepsin in both diagnosis and follow-up of early-onset neonatal sepsis (EOS) and also to compare its effectiveness with C-reactive protein (CRP) and procalcitonin (PCT). Methods A total of 29 term infants with EOS group and 40 term infants with control group were included in this study. Before initiating therapy, blood samples for whole blood count, CRP, PCT, presepsin, and culture were obtained from all neonates (T0). This procedure was repeated two times at 72 hours (T3) and day 7 (T7). Results Presepsin levels of sepsis group at T0 were significantly higher (704.27 ± 223.54 pg/mL) than the control group (508.33 ± 165.46 pg/mL). The sensitivity of CRP, PCT, and presepsin at T0 was found to be 83, 67, and 80%, whereas the specificity was found to be 75, 67, and 75%, respectively. The cutoff value for presepsin was 539 pg/mL with an area under the curve of 0.772. Conclusion Presepsin may be used as a reliable and accurate marker for both diagnosis and follow-up of EOS. However, to increase the accuracy, presepsin may be used in combination with other markers such as CRP and PCT.

Accuracy of Presepsin in Sepsis Diagnosis: A Systematic Review and Meta-Analysis.

ObjectiveIt’s difficult to differentiate sepsis from non-sepsis, especially non-infectious SIRS, because no good standard exists for proof of infection. Soluble CD14 subtype (sCD14-ST), recently re-named presepsin, was identified as a new marker for the diagnosis of sepsis in several reports. However, the findings were based on the results of individual clinical trials, rather than a comprehensive and overall estimation. Thus, we conducted this systematic review and meta-analysis to estimate the pooled accuracy of presepsin in patients with sepsis suspect.MethodsA comprehensive electronic search was performed via internet retrieval system up to 15 December 2014. Methodological quality assessment was applied by using the QUADAS2 tool. The diagnostic value of presepsin in sepsis was evaluated by using the pooled estimate of sensitivity, specificity, likelihood ratio, and diagnostic odds ratio, as well as summary receiver operating characteristics curve.ResultsNine studies with 10 trials and 2159 cases were included in the study. Only two trials had low concerns regarding applicability, whereas all trials were deemed to be at high risk of bias. Heterogeneity existed in the non-threshold effect, but not in the threshold effect. The pooled sensitivity of presepsin for sepsis was 0.78 (0.76–0.80), pooled specificity was 0.83 (0.80–0.85), pooled positive likelihood ratio was 4.63 (3.27–6.55), pooled negative likelihood ratio was 0.22 (0.16–0.30), and pooled diagnostic odds ratio was 21.73 (12.81–36.86). The area under curve of summary receiver operating characteristics curve was 0.89 (95%CI: 0.84 to 0.94) and Q* index was 0.82 (95%CI: 0.77 to 0.87).ConclusionThis meta-analysis demonstrates that presepsin had some superiority in the management of patients, and may be a helpful and valuable biomarker in early diagnosis of sepsis. However, presepsin showed a moderate diagnostic accuracy in differentiating sepsis from non-sepsis which prevented it from being recommended as a definitive test for diagnosing sepsis in isolation, but the results should be interpreted cautiously.

Presepsin as a Novel Diagnostic Marker in Neonatal Septicemia

Background: Neonatal septicemia is a serious life-threatening condition with high mortality. The accurate diagnosis of sepsis is one of the main challenges in emergency medicine. A great effort to reduce the neonatal mortality rate is put into looking for new reliable biomarkers. Among biomarkers, presepsin could be one of the most promising and reliable biomarker for early diagnosis of sepsis. Objective: We aimed to evaluate the diagnostic value ofpresepsin in the early diagnosis of neonatal sepsis. Methodology: By chemiluminescent enzyme immunoassay (CLEIA), the level of presepsin was assessed in 40 full term neonates with suspected sepsis (Proven sepsis group: 23 patients with +ve blood culture & Probable sepsis group: 17 patients with -ve blood culture) and15 healthy full term neonates. Results: Presepsin level was found to be significantly higher in patient group than control group as well as in proven sepsis group than probable sepsis group. The cut off value for presepsin was 875pg/ml at which the sensitivity and specificity of presepsin were (95.7%, 87.5%) respectively. Presepsin level was found to be significantly higher in females than males. There was no significant difference in the presepsin level as regard mode of delivery nor onset of sepsis. Conclusion: Presepsin is a novel biomarker with high sensitivity and good specificity for sepsis and its measurement can be useful for early diagnosis of neonatal sepsis.