Presepsin: A Anew Marker for Early Diagnosis of Septicemia

Abstract
Background: Sepsis is a life-threatening condition that arises when the body's response to an infection and injures of its own tissues and organs. The fatality rate of patients with sepsis has remained as high as 30-60% despite advances in antibiotic therapy and modern life support.
Aim of Study: Early and rapid diagnosis of septicemia by presepsin and comparing its level to the blood culture technique as a gold standard for diagnosis of septicemia.
Patients and Methods: This is a case control study. Forty five (45) post traumatic patient admitted to Intensive Care Unit (ICU) in Assiut University Hospitals who met one or more of the inclusion criteria (according to American College of Chest Physicians ACCP)/Society of Critical Care Medicine (SCCM), in addition to 15 apparently healthy subject as control group matching for age and sex. PATHFAST® Presep-sin is a Chemiluminescent Enzyme Immunoassay (CLEIA) for the quantitative measurement of presepsin concentration in whole blood or plasma were used.
Results: In this study, the reference limits of presepsin were 57-337pg/ml, the sensitivity and specificity of presepsin were 97.1% and 63.6% respectively in comparing to the sensitivity and specificity of WBCs was 63% and 11% respec-tively and the sensitivity and specificity of hsCRP was 64% and 63% respectively. The diagnostic value in the present study were set (879.73±403.9pg/ml) for SIRS group, (1011.19 ±219.3pg/ml) for sepsis group, and (1621.1±429.95) for severe sepsis group. The presepsin level was significantly increased in patients with positive blood culture (sepsis and severe sepsis group) comparing to patient with negative blood culture (SIRS group) at the time of admission and after 3 day follow-up. Also a significant increase in presepsin levels was observed compared to controls in the lowest to highest groups of sepsis severity during the first 3 day of intensive care treatment (p <0.001), which was not observed for WBCs and hsCRP.
Conclusion: The presepsin has a higher sensitivity and specificity in early diagnosis of sepsis as a biomarker, and its concentrations is not only useful for diagnosis of sepsis and evaluating its severity, but also used as a predictor for the prognosis of sepsis.