05 | Role of presepsin in multimarkers approach for early diagnosis of sepsis

Abstract

Introduction. Sepsis is an exaggerated inflammatory response to infection, requiring early and accurate treatment. However, its diagnosis is challenging due to varied clinical presentations. A prospective study on Presepsin was conducted in the ED of Policlinico Agostino Gemelli. Presepsin (sCD14-ST) is a fragment of soluble CD14 released into the bloodstream by monocytes in response to infection.

Methods. Patients over 18 years who were able to sign the informed consent were enrolled thanks to a venous blood sample in EDTA. The study pool included 216 patients from the emergency room, who were suspected of having sepsis.

Results. We classified patients basing on blood cultures results. There were 86 patients with positive blood cultures and, among them, 89.5% had Presepsin levels >165 pg/mL and 65.1% had PCT>0.5 ng/mL.  On the other hand, 130 patients had negative blood cultures, including 36 who were clinically diagnosed with sepsis. In this group 94.4% had Presepsin>165 and 86.1% PCT>0.5. Regardless of blood cultures, biomarkers appear to be effective in identifying sepsis. Additionally, In the remaining 94 patients: 14 were true negatives with PSP<165 and PCT<0.5; 36 had PSP>165 and PCT>0.5 with sepsis diagnosis in ward; 45 patients had one of the two markers below the negative cutoff but the other one above. This is due to the different kinetics of the markers. These 45 patients had an evolving infectious condition.

Conclusions. Our study demonstrated higher sensitivity of Presepsin. Finally, our evidence also suggests the complementarity of the two markers in the diagnosis of sepsis due to their high negative predictive value.

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Supporting Agencies

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Data Availability Statement

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