Presepsin a diagnostic marker for sepsis in intensive care unit patients

The aim of the study was to evaluate the usefulness of presepsin as a diagnostic marker of sepsis in intensive care unit (ICU) patients. Presepsin was measured by a rapid method based on a chemiluminescent enzyme immunoassay (PATHFAST). The clinical usefulness of presepsin to diagnose sepsis and septic shock was studied and compared with procalcitonin, C-reactive protein and total leucocytic count. This study was conducted on 53 individuals divided into 3 groups. Group I included 28 adult ICU patients with at least two diagnostic criteria for systemic inflammatory response syndrome (SIRS) as patient group, Group IIa 15 patients admitted to ICU for any medical cause but with no evidence of infection were enrolled as patient control group and further 10 apparently healthy subjects as healthy control group. Patients were further subdivided retrospectively according to the final diagnosis into:
patients with sepsis 16 (57.1%) and septic shock 12 (42.9%), from which 17 (59.3%) improved while 11(39.3%) did not survive. The presepsin values were significantly higher in patients with sepsis than the control groups. The area under ROC curve (AUC) for discriminating sepsis from non septic conditions for presepsin was greater than the AUC of PCT, CRP or TLC. This suggests that presepsin has high specificity and sensitivity for sepsis diagnosis. In conclusion, presepsin can be used as a useful biomarker for the diagnosis of sepsis. It is readily available, cost-effective and able to distinguish septic patients in a complex population.