Presepsin and Procalcitonin as Potential Biomarkers for Early Diagnosis and Prognosis of Sepsis in Critically Ill Patients ()
ABSTRACT
Background: Sepsis has a poor prognosis for critically ill patients, even with intensive management. Early diagnosis of sepsis and
detection of patients with worsening prognosis are important for
immediate intervention to improve the clinical outcome. Objective: To
investigate serum presepsin (PS) and procalcitonin (PCT) as early diagnostic
and prognostic biomarkers for sepsis in critically ill patients. Methods: 60 critically ill patients with sepsis were subdivided into three groups of
sepsis, severe sepsis and septic shock according
to Acute Physiology and Chronic Health Evaluation II (APACHEII) and quick Sequential Organ Failure Assessment
(qSOFA) scores. Patients were compared with 20 age and sex matched
controls. Serum PS and PCT were measured by enzyme linked immunosorbent assay
(ELISA). Results: Serum PS and PCT levels were significantly increased
in septic patients than controls, and their increase was positively correlated
with progression of sepsis severity till reached the highest levels in septic
shock. Receiver operating characteristic
(ROC) curve for predicting sepsis revealed that PS has the highest area
under curve (AUC) (0.967) with 97.5% sensitivity, 85% specificity and cut-off
of >635.5 pg/mL,
followed by PCT that has AUC (0.946), 97.5% sensitivity, 95% specificity and
cut-off of >319.7 pg/mL.
C-reactive protein (CRP) showed the lowest AUC (0.902) with 75% sensitivity,
100% specificity and cut-off of >7 mg/L. ROC curve for predicting septic
shock showed that PS has the highest AUC (0.969) with 90% sensitivity, 97.5%
specificity and cut-off of >5500.6 pg/mL, followed by CRP that has AUC
(0.945), 90% sensitivity, 87.5% specificity and cut-off of >63 mg/L. PCT
showed the lowest AUC (0.889) with 90% sensitivity, 97.5% specificity and
cut-off of >822.1 pg/mL. Conclusions: Serum PS and PCT were promising
biomarkers for early diagnosis and prognosis of sepsis in critically ill
patients, but PS was superior to PCT.
Share and Cite:
Sabry, R. , Maghraby, H. and Allah, A. (2021) Presepsin and Procalcitonin as Potential Biomarkers for Early Diagnosis and Prognosis of Sepsis in Critically Ill Patients.
Open Journal of Medical Microbiology,
11, 267-281. doi:
10.4236/ojmm.2021.113017.