Soluble CD14 Subtype (Presepsin) Assay for Early Diagnosis of Sepsis in Egyptian Patients

Abstract
Background: Despite advances in therapy, sepsis is the leading cause of death in critical care settings. The early recognition of sepsis as well as the speed and appropriateness of therapy in the initial hours after presentation are likely to influence the outcomes of septic patients. This study was conducted to investigate the early diagnostic and differentiating value of pathfast presepsin assay (soluble CD14 subtype) compared to other biomarkers in patients presenting at emer-gency department with systemic inflammatory response syn-drome and suspected sepsis.
Methods: The current study included seventy suspected septic patients (patient group) and thirty apparently healthy individuals (control group). All subjects were subjected at first presentation to determination of plasma presepsin, quan-titative C-reactive protein and total leucocytic count values, while patient group were subjected to blood culture as a gold standard method.
Results: Presepsin levels showed a statistically significant increase between septic and systemic inflammatory response patients. The cut off value that gave the best sensitivity and specificity for presepsin was 395pg/ml.
Conclusions: Presepsin can be a very useful promising biomarker not only for the early diagnosis of sepsis (15min) with discrimination between sepsis and systemic inflammatory response syndrome in patient presented in ED, but also for assessment of its severity and prognosis. Higher level was correlated with poor patient outcome. Future studies on large scale are needed to monitoring of prespsin level in response to antibiotic treatment.