Presepsin as an Early Predictor of Neonatal Sepsis

Background pathogens stimulate presepsin (p-sep) shedding from immune cells such as macrophages, monocytes, and neutrophils. although its function is still unclear, p-sep is believed to interact with b and t cells to modulate specific immune responses. we aimed to evaluate the accuracy of p-sep as a novel biomarker for the diagnosis of bacterial infection and correlate its level with blood culture, c-reactive protein (crp), and procalcitonin (pct) levels. materials and methods: this is a prospective comparative study conducted at minia university hospital, egypt, including eighty neonates. they were divided into two groups: group i: twenty full term neonates; infants ≥ 37 weeks. group ii: sixty preterm neonates <37 weeks, it was classified into three subgroups; group ii a: 20 low birth weight neonates: 1501- 2500 gr, group ii b: 20 very low birth weight neonates: 1001-1500 gr, group ii c: 20 extremely low birth weight neonates: 500-1000 gr. cord presepsin (presepsin 1) was measured at birth. cbc, crp, blood culture, procalcitonin and presepsin 2 were measured after the onset of sepsis. results: no significant difference in levels of p-sep 1 was found between the two groups. p-sep 2 levels were higher in sepsis group than in non-sepsis group. presepsin showed more diagnostic accuracy than pct in diagnosis of sepsis. the best cut-off value for presepsin was 485 pg/ml, with 97.8% sensitivity, and 94.1% specificity. conclusion presepsin as a biomarker is not only suitable for early diagnosis of sepsis but it is also more accurate than both pct and crp.