Value of Presepsin in the Diagnosis of Neonatal Sepsis in Genetic Disorders

Abstract

Sepsis syndrome is SIRS caused by microbial products, viruses or fungi. Neonatal sepsis (NS), sepsis neonatorum or neonatal septicemia is defined as sepsis which occurs in the first 4 weeks of life and it is further classified into EOS which occurs in the first 72 hours and LOS which starts after 72 hours. Definite and early diagnosis of neonatal sepsis is important for avoiding its fatal outcomes and improving the prognosis of patients especially because symptoms and signs are non specific. It can be confused with many conditions that may occur in this age period which may be non infectious and has more favorable outcome than sepsis. An accurate inflammatory marker with high diagnostic sensitivity, specificity and NPV for neonatal sepsis would be a valuable tool for therapeutic decision-making and avoidance of unnecessary use of antibiotics. Currently used methods in diagnosis have many obstacles ranging from poor sensitivity in case of using blood culture or IT ratio to non specificity in case of depending on CRP. CD14 is present in macrophage, monocyte, and granulocyte cells and their cell membranes, and it is said to be responsible for intracellular transduction of endotoxin signals. Its soluble fraction is present in blood and is thought to be produced in association with infections. It has been previously reported that presepsin is produced in association with infection and that it is specifically expressed in sepsis.