Diagnostic and prognostic value of sCD14-ST—presepsin for patients admitted to hospital intensive care unit (ICU)
- 390 Downloads
Sepsis is a serious problem in intensive care units all over the world. Biomarkers could be useful to identify patients at risk. We focused especially on the performance of presepsin (sCD14-ST), compared to C-reactive protein (CRP), procalcitonin (PCT) and CD64, to determine its diagnostic and prognostic indications.
The study was conducted on 47 hospitalized patients after procedures, who were divided into three groups; systemic inflammatory response (SIRS), sepsis and septic shock. Expression of CD64 on neutrophils presented as CD64 index, sCD14-ST, CRP and PCT were measured in whole blood or plasma samples. All patients had standard samples like urine, respiratory tract samples etc. taken for culturing. Blood cultures were drawn to confirm bloodstream infection.
Forty (85 %) patients had SIRS with bacterial infection and seven (15 %) patients had SIRS with no infection. All infections were confirmed with blood cultures. Biomarkers were evaluated in all patients. In patients with confirmed infection the values were high. The patients with bacterial infection showed statistical significance with CD64 index (p = 0.003), CRP (p = 0.049) and sCD14-ST (p = 0.026), but not with PCT (p = 1.000). The severity of diagnosed SIRS was significant only with PCT (p < 0.001).
CD64 index, CRP and sCD14-ST served as good parameters to determine possible infection in patients that needed intensive care after major procedures. Values of PCT were the only ones to predict SIRS severity and could distinguish between sepsis and severe sepsis or septic shock.
KeywordsInflammatory biomarkers Infection SCD14-ST CD64 CRP PCT Sepsis recognition
M. Godnic and D. Stubljar contributed equally to the article.
Conflict of interests
M. Godnic, D. Stubjar, M. Skvarc, and Tomislav Jukic declare that there are no actual or potential conflicts of interest in relation to this article.
- 1.Prashant A, Vishwanath P, Kulkarni P, Sathya Narayana P, Gowdara V, Nataraj SM, et al. Comparative assessment of cytokines and other inflammatory markers for the early diagnosis of neonatal sepsis—A case control study. PLoS One. 2013;8(7):e68426.doi: 10.1371/journal.pone.0068426.PubMedCentralPubMedCrossRefGoogle Scholar
- 3.Levy MM, Artigas A, Phillips GS, Rhodes A, Beale R, Osborn T, et al. Outcomes of the surviving sepsis campaign in intensive care units in the USA and Europe: a prospective cohort study. Lancet Infect Dis. 2012;12(12):919–24. doi:10.1016/S1473-3099(12)70239-6.Google Scholar
- 5.Jordana-Lluch E, Carolan HE, Giménez M, Sampath R, Ecker DJ, Quesada MD, et al. Rapid diagnosis of bloodstream infections with PCR followed by mass spectrometry. PLoS One. 2013;23:8(4):e62108. doi: 10.1371.Google Scholar
- 12.Groselj-Grenc M, Ihan A, Derganc M. Neutrophil and monocyte CD64 and CD163 expression in critically ill neonates and children with sepsis: comparison of fluorescence intensities and calculated indexes. Mediators Inflamm. 2008. doi: 10.1155/2008/202646.Google Scholar
- 13.Hirakata Y, Yanagihara K, Kurihara S, Izumikawa K, Seki M, Miyazaki Y, et al. Comparison of usefulness of plasma procalcitonin and C-reactive protein measurements for estimation of severity in adults with community-acquired pneumonia. Diagn Microbiol Infect Dis. 2008;61:170–4.PubMedCrossRefGoogle Scholar
- 16.Jeschke MG, Finnerty CC, Kulp GA, Kraft R, Herndon DN. Can we use C-reactive protein levels to predict severe infection or sepsis in severely burned patients? Int J Burn Trauma. 2013;3(3):137–43.Google Scholar
- 23.Spanuth E, Wilhelm J, Loppnow H, Ebelt H, Ivandic B, Werdan K. Diagnostic and prognostic value of presepsin (soluble CD14 subtype) in emergency patients with early sepsis using the new assay PATHFAST presepsin. IFCCWorldLab- EuroMedLab 2011, Berlin.Google Scholar
- 24.Skvarc M, Stubljar D, Rogina P, Kaasch AJ. Non-culture-based methods to diagnose bloodstream infection: Does it work? Eur J Microbiol Immunol. 2013;3(2):97–104. doi: 10.1556/EuJMI.3.2013.2.2.Google Scholar
- 31.Sargentini V, Ceccarelli G, D’Alessandro M, Collepardo D, Morelli A, D'Egidio A, et al. Presepsin as a potential marker for bacterial infection relapse in critical care patients. A preliminary study. Clin Chem Lab Med 2014; doi:10.1515/cclm-2014-0119. [Epub ahead of print]Google Scholar
- 32.Shozushima T, Takahaski G, Matsumoto N, Kojika M, Okamura Y, Endo S. Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome. J Infect Chemother. 2011;17:764–9.PubMedCrossRefGoogle Scholar
- 37.Romualdo LG, Torrella PE, González MV, Sánchez RJ, Holgado AH, Freire AO, et al. Diagnostic accuracy of presepsin (soluble CD14 subtype) for prediction of bacteremia in patients with systemic inflammatory response syndrome in the Emergency Department. Clin Biochem. 2014;47(7–8):505–8.PubMedCrossRefGoogle Scholar