الفهرس 
Title : Study the Use of Presepsin as a Sensitive Biomarker in Diagnosis of Early Onset Sepsis and its Relation to C-Reactive Protein
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Abstract
Background: Neonatal sepsis remains a leading cause of morbidity and
mortality among infants, especially in low socioeconomic countries. Blood
culture is the cornerstone for diagnosis of neonatal sepsis. Because of its
delayed results and due to the increasing need for rapid diagnosis of sepsis, it
becomes very important to search for new serum biomarkers which allow rapid
diagnosis of sepsis and designing treatment plans accordingly to improve
outcome of infants.
Aim of the work: The aim of the work is to detect cut-off, sensitivity and
specificity of presepsin as a biomarker for the diagnosis of early-onset neonatal
sepsis on preterm (PT) babies and its relation to CRP.
Methods: This case-control study has been conducted on sixty preterm infant
recruited from the NICU of Obstetrics and Gynecology Hospital, Cairo
University. 60 infants were divided into two groups; the suspected EOS group:
30 neonates (20 male and 10 female) with maternal history suspecting
septicemia and the control group: 30 neonates(17 male and 13 female) without
maternal history suspecting septicemia and admitted to NICU as grower, The
medical history, maternal data, neonatal date and needed investigations were
done and collected from patient’s files while presepsin investigation was done
in Abu-Elreish Hospital laboratory by enzyme-linked immunosorbent assay
(ELISA), All preterm infants were accurately observed with documentation of
all events done during hospital stay with special reference to presepsin results,
different lines of treatment and outcome
Results: Presepsin levels in the suspected EOS group were higher at 6 hours of
life compared to the control group (P<0.001) and there were highly statistically
significant difference (P<0.001) in the suspected EOS group regarding the
relation between presepsin and CRP in diagnosis of EOS at 6 hours and 24
hour age of life. The area under the receiver operating characteristics (ROC)
curve (AUC) for presepsin was 0.963 with sensitivity 96.30 % and specificity
of 100.00 % with cut-off value > 454 ng/ml at 6 hour of age, patients above this
level are considered septic with PPV=100.00% and NPV=75.00 % while the
area under the receiver operating characteristics (ROC) curve (AUC) for
presepsin was 0.963 with sensitivity 96.30 % and specificity of 100.00 % with
cut-off value > 527 ng/ml at 24 hour of age, patients above this level are
considered septic with PPV=100.00 % and NPV=75.00 %.
Conclusion: Presepsin is a sensitive and accurate serum biomarker for
diagnosis of sepsis