Comparison between presepsin and procalcitonin in early diagnosis of neonatal sepsis.

Abstract

Background: Neonatal sepsis remains worldwide one of the leading causes of morbidity and mortality in both term and preterm infants. Lower mortality rates are related to timely diagnostic evaluation and prompt initiation of empiric antibiotic therapy. Blood culture, as gold standard examination for sepsis, has several limitations for early diagnosis, so that sepsis biomarkers could play an important role in this regard. This study was aimed to compare the value of the two biomarkers presepsin and procalcitonin in early diagnosis of neonatal sepsis. Methods: This was a prospective cross-sectional study performed in Saiful Anwar General Hospital Malang, Indonesia, in 51 neonates that fulfill the criteria of systemic inflammatory response syndrome (SIRS) with blood culture as diagnostic gold standard for sepsis. Results: At reviewer operating characteristic (ROC) curve analyses, using a presepsin cutoff of 706.5 pg/mL, the obtained area under the curve (AUCs) were sensitivity = 85.7%, specificity = 68.8%, positive predictive value = 85.7%, negative predictive value = 68.8%, positive likelihood ratio = 2.75, negative likelihood ratio = 0.21, and accuracy = 80.4%. On the other hand, with a procalcitonin cutoff value of 161.33 pg/mL the obtained AUCs showed: sensitivity = 68.6%, specificity = 62.5%, positive predictive value = 80%, negative predictive value = 47.6%, positive likelihood ratio = 1.83, the odds ratio negative = 0.5, and accuracy = 66.7%. Conclusions: In early diagnosis of neonatal sepsis, compared with procalcitonin, presepsin seems to provide better early diagnostic value with consequent possible faster therapeutical decision making and possible positive impact on outcome of neonates.

• Authors: Agustin Iskandar, Maimun Z Arthamin, Kristin Indriana, Muhammad Anshory, Mina Hur, Salvatore Di Somma, GREAT Network
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 32 Issue 23 Pg. 3903-3908 (Dec 2019) ISSN: 1476-4954 [Electronic] England
• PMID: 29742943 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Chemical References

• Biomarkers
• Lipopolysaccharide Receptors
• Peptide Fragments
• Procalcitonin
• presepsin protein, human

Topics

• Biomarkers (blood)
• Cross-Sectional Studies
• Early Diagnosis
• Female
• Humans
• Infant, Newborn
• Lipopolysaccharide Receptors (blood)
• Male
• Neonatal Screening (methods)
• Neonatal Sepsis (blood, complications, diagnosis)
• Peptide Fragments (blood)
• Predictive Value of Tests
• Procalcitonin (blood)
• Sensitivity and Specificity
• Systemic Inflammatory Response Syndrome (blood, complications, diagnosis)