Diagnostic Value of Presepsin (Scd14-St Subtype) Evaluation in the Detection of Severe Neonatal Infections

Abstract: The clinical usefulness of assesment of presepsin concentration in peripheral vein blood in male and female severe infected newborns, including their birth weight, fetal maturity, gender, birth asphyxia, mode of mother’s delivery was studies and compared with C-reactive protein, procalcitonin, hemoglobine, hematocrit and platelet count in a multicenter prospective study. The study population comprised 124 newborns (41 septic, 37 with severe local infections without bacteriemia, 16 without infections, but with clinical symptoms suggesting infection and perinatal risk factors and 30 healthy as control), in which by rapid chemiluminescent enzyme immunoassay, using fully automated PATHFAST TM analyser from Mitsubishi Kagaku Iatron Inc, presepsin concentration in whole blood was measured. The mean presepsin concentration in septic newborns, independently of their gender, fetal maturity, birth asphyxia (1389±861 pg/ml) was significantly (p<0,001) higher than in others newborns. In severe local infected newborns (mainly pneumonic, with negative blood cultures) independently of their fetal maturity, birth asphyxia and mode of delivery, significant presepsin increase than in noninfected newborns was stated. Positive correlation between presepsin and CRP concentrations, negative correlation between presepsin and hemoglobin, hematocrit value and platelet count in septic newborns were noted. Positive correlation between presepsin and procalcitonin in local infected newborns was observed. The cutoff value of presepsin for discrimination of neonatal sepsis was determined to be 1066 pg/ml, of which the clinical specyfity and sensivity were 89,2% and 63,4%, respectively. Presepsin determination might be used as a high specyfity biomarker for the early diagnosis of neonatal sepsis and severe local infections, both early and late-onset.