Background: Presepsin is secreted in response to bacterial phagocytosis, and it has been found that people with liver cirrhosis are at a higher risk of developing bacterial infections. We aimed to evaluate the diagnostic role of presepsin in Patients with liver cirrhosis and bacterial infection.

Methods: Our case-control study included 96 cases with liver cirrhosis, divided into 2 groups according to the results of culture and sensitivity. Group I involved 48 patients with liver cirrhosis (child B or C) with a bacterial infection. Group II: involved 48 cases with liver cirrhosis (child B or C) without bacterial infection. Estimation of serum presepsin level was done for all participants.

Results: The C reactive protein (CRP), serum procalcitonin, and presepsin (Log PSP) were significantly higher among cirrhotic patients cases with bacterial infection with p-value <0.001 for each when compared to cirrhotic patients without bacterial infection, significant positive correlations were found between Log(PSP) and both CRP and serum procalcitonin (p=0.004, 0.003 respectively). At a cut-off value of <3.1 log PSP could diagnose bacterial infection with the area under the curve 0.698, with specificity of 63.3%, sensitivity of 54.2%, positive predictive value (PPV) 66.5%, negative predictive value (NPV) 64.5% and overall accuracy 68.8%. The combination of CRP and Log PSP had the best diagnostic value with sensitivity of 95.8%, specificity 93.7%, PPV 93.9%, and NPV 95.7%.

Conclusions: Presepsin can play a role in diagnosing bacterial infection in patients with liver cirrhosis. Presepsin and CRP increased the diagnostic accuracy of bacterial infection in cirrhotic patients.