Is Presepsin a Reliable Marker of Sepsis Diagnosis in Pediatric Intensive Care Unit?

  • Hebat-Allah Algebaly Department of Pediatrics, Cairo University, Cairo, Egypt
  • Hala M. Fouad Department of Pediatrics, Cairo University, Cairo, Egypt
  • Maha M. Elkholy Department of Pediatrics, Cairo University, Cairo, Egypt
  • Sally K. Ibrahim Department of Pediatrics, Cairo University, Cairo, Egypt
  • Nermin M. Riad Department of Clinical and Chemical Pathology, Cairo, Egypt
Keywords: Presepsin, Sepsis, Severe sepsis, Septic shock

Abstract

BACKGROUND: Sepsis is a major challenge in emergency departments and intensive care units (ICUs). Sepsis also mimics or interacts with many other disorders causing high mortality and morbidity. There is no accurate biomarker or test to diagnose or predict sepsis. The treatment of sepsis is often based on the clinician’s experience.

AIM: We conducted this study to analyze the serum level of presepsin in pediatric critical patients with SIRS, sepsis, severe sepsis, and septic shock.

METHODS: The study included 58 children, 32 septic pediatric patients admitted to the Pediatric ICU (PICU) of Cairo University Teaching Hospital and 26 healthy children who served as a control group. The aim was to estimate the diagnostic accuracy of presepsin in predicting sepsis in PICU. We classified the patients into systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock according to the international consensus conference criteria.

RESULTS: In our study, we detected a positive correlation between C-reactive protein and presepsin levels at day 1 and day 3 of admission and a negative correlation between hemoglobin and presepsin levels at day 1. However, we found no difference in the serum presepsin between the children who had sepsis and the healthy ones (at day 1 [p = 0.430) and at day 3 [p = 0.845]). We also found that serum levels of presepsin were not significantly increased with the increasing severity of sepsis despite the higher median values with increasing sepsis severity.

CONCLUSIONS: It was noted that presepsin levels increased in anemic critical patients, whereas presepsin had no role in differentiating the septic critical patients from healthy children. However, its level increased with increasing severity of sepsis grade.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Wu J, Hu L, Zhang G, Wu F, He T. Accuracy of presepsin in sepsis diagnosis: A systematic review and meta-analysis. PLoS One. 2015;10(7):e0133057. https://doi.org/10.1371/journal. pone.0133057 PMid:26192602

Patton L, Young V. Effectiveness of provider strategies for the early recognition of clinical deterioration due to sepsis in pediatric patients: A systematic review protocol. JBI Database System Rev Implement Rep. 2017;15(1):76-85. https://doi. org/10.11124/jbisrir-2016-003237 PMid:28085729

Kristina R, Niranjan K, Direk L, Bory S, Mutahunga B, Seymour CW, et al. The global burden of sepsis: Barriers and potential solutions. Crit Care. 2018;22(1):232. PMid:30243300

Kristina R, Sarah J, Kareha A, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: Analysis for the global burden of disease study. Lancet. 2020;395(10219):200-11. PMid:31954465

Zhang J, Hu Z, Song J, Shao J. Diagnostic value of presepsin for sepsis: A systematic review and meta-analysis. Medicine (Baltimore). 2015;94(47):e2158.

Abbas Q, Ul Haq A, Kumar R, Ali SA, Hussain K, Shakoor S. Evaluation of antibiotic use in pediatric intensive care unit of a developing country. Indian J Crit Care Med. 2016;20(5):291-94. https://doi.org/10.4103/0972-5229.182197 PMid:27275078

Viderman D, Brotfain E, Khamzina Y, Kapanova G, Zhumadilov A, Poddighe D. Bacterial resistance in the intensive care unit of developing countries: Report from a tertiary hospital in Kazakhstan. J Glob Antimicrob Resist. 2018;17:35-8. https:// doi.org/10.1016/j.jgar.2018.11.010 PMid:30448518

Bellos I, Fitrou G, Pergialiotis V, Thomakos N, Perrea DN, Daskalakis G. The diagnostic accuracy of presepsin in neonatal sepsis: A meta-analysis. Eur J Pediatr. 2018;177(5):625-32. https://doi.org/10.1007/s00431-018-3114-1 PMid:29476345

Parri N, Trippella G, Lisi C, De Martino M, Galli L, Chiappini E. Accuracy of presepsin in neonatal sepsis: Systematic review and meta-analysis. Expert Rev Anti Infect Ther. 2019;17(4):223-32. https://doi.org/10.1080/14787210.2019.1584037 PMid:30775935

Van-Maldeghem I, Nusman M, Visser H. Soluble CD14 subtype (sCD14-ST) as biomarker in neonatal early-onset sepsis and late-onset sepsis: A systematic review and meta-analysis. BMC Immunol. 2019;20(1):17. https://doi.org/10.1186/ s12865-019-0298-8 PMid:31159729

Chenevier-Gobeaux C, Borderie D, Weiss N, Mallet- Coste T, Claessens YE. Presepsin (sCD14-ST), an innate immune response marker in sepsis. Clin Chim Acta. 2015;450:97-103. https://doi.org/10.1016/j.cca.2015.06.026 PMid:26164388

Yoon H, Kim H, Kim Y, Ahn JG. Presepsin as a diagnostic marker of sepsis in children and adolescents: A systemic review and meta-analysis. BMC Infect Dis. 2019;19(1):760. https://doi. org/10.1186/s12879-019-4397-1 PMid:31470804

Goldstein B, Giroir B, Randolph A. International Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005;6(1):2-8. https://doi.org/10.1097/01.pcc.0000149131.72248.e6 PMid:15636651

Gogia P, Koreti SS. SOFA (sequential organ failure assessment) and PELOD (pediatric logistic organ dysfunction). Sch J Appl Med Sci. 2015;3(4A):1645-8.

Chan Y. Biostatistics102: Quantitative data-parametric and non-parametric tests. Singapore Med J. 2003;44(8):391-6. PMid:14700417

Chan YH. Biostatistics 104: Correlational analysis. Singapore Med J. 2003;44(12):614-9. PMid:14770254

Dellinger R, Levy M, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580-637. https://doi.org/10.1097/ ccm.0000000000000192 PMid:23353941

Romualdo L, Torrella P, González M, Sánchez RJ, Holgado AH, Freire AO, et al. Diagnostic accuracy of presepsin (soluble CD14 subtype) for prediction of bacteremia in patients with systemic inflammatory response syndrome in the emergency department. Clin Biochem. 2014;47(7-8):505-8. https://doi. org/10.1016/j.clinbiochem.2014.02.011 PMid:24560955

Hausfater P. Biomarkers and infection in the emergency unit. Med Mal Infect. 2014;44(4):139-45. PMid:24556451

El-Gendy M, El-Mekkawy S, Saleh Y, Habib MS, Younis FE. Clinical study of presepsin and pentraxin 3 in critically ill children. J Crit Care. 2018;47:36-40. https://doi.org/10.1016/j. jcrc.2018.06.004 PMid:29886065

Liu B, Chen X, Yin Q, Zhao YZ, Li CS. Diagnostic value and prognostic evaluation of presepsin for sepsis in an emergency department. Crit Care. 2013;17(5):R244. https://doi.org/10.1186/ cc13070 PMid:24138799

Poggi C, Bianconi T, Gozzini E, Generoso M, Dani C. Presepsin for the detection of late-onset sepsis in preterm newborns. Pediatrics. 2015;135(1):68-75. https://doi.org/10.1542/ peds.2014-1755 PMid:25511124

Nur S, Yalaz M, Altun O, Sozmen E, Akisu M, Kultursay N. Reference ranges of presepsin (soluble CD14 subtype) in term and preterm neonates without infection, in relation to gestational and postnatal age, in the first 28°days of life. Clin Biochem. 2020;77:7-13. https://doi.org/10.1016/j.clinbiochem.2019.12.007 PMid:31843667

Tong X, Cao Y, Yu M, Han C. Presepsin as a diagnostic marker for sepsis: Evidence from a bivariate meta-analysis. Ther Clin Risk Manag. 2015;11:1027-33. https://doi.org/10.2147/tcrm. s84811 PMid:26170681

Zheng Z, Jiang L, Ye L, Gao Y, Tang L, Zhang M. The accuracy of presepsin for the diagnosis of sepsis from SIRS: A systematic review and meta-analysis. Ann Intensive Care. 2015;5(1):48. https://doi.org/10.1186/s13613-015-0089-1 PMid:26642970

Chenevier-Gobeaux C, Trabattoni E, Roelens M, Borderie D, Claessens YE. Presepsin (sCD14-ST) in emergency department: The need for adapted threshold values? Clin Chim Acta. 2014;427:34-6. https://doi.org/10.1016/j.cca.2013.09.019 PMid:24076253

Topcuoglu S, Arslanbuga C, Gursoy T, Aktas A, Karatekin G, Uluhan R, et al. Role of presepsin in the diagnosis of late-onset neonatal sepsis in preterm infants. J Matern Fetal Neonatal Med. 2015;29(11):1834-9. https://doi.org/10.3109/14767058.20 15.1064885 PMid:26135765

Manderwad G, Kumar R. Presepsin: A novel marker for the neonatal sepsis: A brief review. Res Rev. 2018;8(1):22-4.

Rashwan N, Hassan M, El-Deen ZM, Ahmed AE. Validity of biomarkers in screening for neonatal sepsis-a single center-hospital based study. Pediatr Neonatol. 2019;60(2):149-55. https://doi.org/10.1016/j.pedneo.2018.05.001 PMid:29895470

Carpio R, Zapztp J, Spanuth E, Hess G. Utility of presepsin (sCD14-ST) as a diagnostic and prognostic marker of sepsis in the emergency department. Clin Chim Acta. 2015;450:169-75. https://doi.org/10.1016/j.cca.2015.08.013 PMid:26296897

Małgorzata S, Jakub B, Anna S, Anna PB, Aneta S, Urszula GS. Diagnostic value of presepsin (sCD14-ST subtype) evaluation in the detection of severe neonatal infections. Int J Res Stud Biosci. 2015;3(1):110-6.

Motoi U, Yu M, Kei M, Matsuura H. Impact of initial plasma presepsin level for clinical outcome in hospitalized patients with pneumonia. J Thorac Dis. 2019;11(4):1387-1396. https://doi. org/10.21037/jtd.2019.03.74 PMid:31179081

Irena K, Carmela G, Elisa P, Semenzato G, Plebani M, Caputo I, et al. Comparison of presepsin, procalcitonin, interleukin-8 and C-reactive protein in predicting bacteraemia in febrile neutropenic adult patients with haematological malignancies. Mediterr J Hematol Infect Dis. 2019;11(1):e2019047. https://doi. org/10.4084/mjhid.2019.047 PMid:31528313

Stoma I, Karpov I, Uss A, Rummo O, Milanovich N, Iskrov I. Diagnostic value of sepsis biomarkers in hematopoietic stem cell transplant recipients in a condition of high prevalence of gram-negative pathogens. Hematol Oncol Stem Cell Ther. 2017;10(1):15-21. https://doi.org/10.1016/j. hemonc.2016.09.002 PMid:27793578

Qi ZJ, Yu H, Zhang J, Li CS. Presepsin as a novel diagnostic biomarker for differentiating active pulmonary tuberculosis from bacterial community acquired pneumonia. Clin Chim Acta. 2018;478:152-56. https://doi.org/10.1016/j.cca.2017.12.045 PMid:29289622

Mohamed E, Khaled T, Moataz E, Kandeel AM. Role of presepsin compared to C-reactive protein in sepsis diagnosis and prognostication. Egypt J Crit Care Med. 2017;5(1):1-12.

Published
2020-03-05
How to Cite
1.
Algebaly H-A, Fouad HM, Elkholy MM, Ibrahim SK, Riad NM. Is Presepsin a Reliable Marker of Sepsis Diagnosis in Pediatric Intensive Care Unit?. Open Access Maced J Med Sci [Internet]. 2020Mar.5 [cited 2020Oct.31];8(B):66-0. Available from: https://www.id-press.eu/mjms/article/view/3431