The diagnostic and prognostic values of soluble CD14 subtype (presepsin) in detection of early onset neonatal sepsis in preterm newborns.

Abstract

BackgroundNeonatal early onset sepsis [EOS] continues to impact the neonatal morbidity and mortality rates worldwide. The diagnosis of suspected EOS in the neonatal intensive care unit (NICU) remains an important challenge for clinicians as the signs of sepsis are often nonspecific and the laboratory investigations may be unreliable or not routinely available.Presepsin (P-SEP) or soluble clusture of Differentiation 14 Subtype (SCD14-ST) is generated as a part of the body's response to bacterial infection, being effective in the early phase of inflammation and detected as an early marker of neonatal sepsis.This study aimed to evaluate the diagnostic value of presepsin in early-onset sepsis, and its prognostic value regarding disease severity, and duration of hospital stay. Moreover, the study aimed to assess the possible predictive ability of presepsin in identifying the type of bacterial organism causing early-onset sepsis in preterm neonates.Materials and methodsThe study recruited 36 preterm neonates with risk factors for early onset sepsis. Control group included 20 sepsis free neonates. Serum Presepsin levels, CRP and blood culture were tested in all studied neonates.ResultsThe predictive performance of presepsin levels between 640 and 970 ng/L was evaluated, and the associated clinical implications were analyzed. The serum baseline presepsin was significantly elevated in Sepsis group (p < 0.001). Moreover, it showed the best diagnostic performance at a cutoff value ≥640 ng/L.Day 3 Presepsin levels demonstrated better performance than day 1 levels in gram negative infections with the best Predictive performance at a cutoff value ≥970 ng/L.ConclusionPresepsin evaluation in preterm neonates may serve as a valuable early marker in detection of early onset sepsis and in distinguishing gram-negative bacteria.