Background: The diagnosis of neonatal sepsis requires careful clinical suspicion, detailed physical examination, and a combination of laboratory tests and radiological tests. Although there isn't one single test that can reliably diagnose sepsis in all neonates, the above combination will establish the diagnosis in most cases.
Objective: To evaluate the efficacy of Presepsin in both diagnosis and follow-up of early-onset neonatal sepsis.
Patients and Methods: This prospective study aimed to determine the diagnostic utilities [sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV)] of Presepsin for early detection of neonatal sepsis, and to define the optimal cutoff value for Presepsin using the receiver operating characteristics (ROC) curve, so that it may be used as a reference with which future studies can be compared. This prospective study had been carried out in the Neonatal Intensive Care Unit at El-Galaa Teaching hospital during the period from October 2018 to April 2019. This study was conducted on 45neonates; 25 cases and 20 healthy neonates were enrolled as a healthy control group.
Results: There was significant correlation between both Presepsin and the hematological data (Total leucocytic count, band cells, segmented neutrophils, platelets and immature to total ratio) of the cases. Presepsin had a significant correlation with CRP level which is a laboratory marker of neonatal sepsis. We found that the median level of Presepsin was higher in cases group than control group. ROC curve shows Presepsin value of 0.64 ng/dl was established as a cut off value with 88% sensitivity and 100% specificity. The positive and negative predictive values were 100% and 87%respectively
Conclusion: Presepsin is a novel biomarker with high sensitivity and good specificity for sepsis and its measurement can be useful for early diagnosis of neonatal sepsis. Also it was found to be beneficial as a prognostic tool to predict outcome of sepsis in neonatal intensive care and shown to have a correlation with survival.