Zhuravleva L.N. Novikova V.I.
The significance of the blood serum biomarker presepsin in pneumonia in premature newborns
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2020;19(4):46-52.
Introduction. In the neonatal period, infectious pathology has nonspecific clinical manifestations, which can lead to difficulties in the interpretion of symptoms and late diagnosis of the disease.
Objectives. To determine the diagnostic significance of the blood serum presepsin (PSP) concentration in premature newborns with respiratory disorders for the early diagnosis of pneumonia.
Material and methods. We included 62 preterm infants with the gestational age of 27-36 weeks in our research work. Respiratory pathology was observed in 47 newborns (congenital pneumonia was diagnosed in 20 children, and respiratory distress syndrome (RDS) – in 27 of them), and 15 preterm infants made up the control group.
Results. On the 1st – the 3rd day of life the analysis of presepsin concentration allowed to reveal that this early inflammatory marker was increased in children with respiratory pathology. Moreover, in children with congenital pneumonia this inflammatory marker was statistically increased compared to children with RDS (358.9 [279.8-675.7] and 245.6 [125-353], respectively). The same tendency remained in the dynamics of the neonatal period when we reexamined this indicator on the 7th – the 10th day of life. We found a statistically significant (p<0.05) positive interrelationship between blood serum presepsin level on the 1st – the 3rd day of life and the duration of mechanical ventilation (R=0.34; p=0.02), as well as between the PSP concentration on the 1st – the 3rd day of life and the number of days of antibiotic therapy (R=0.27, p=0.002).
Conclusions. The presepsin concentration of 325 ng / l in blood serum on the first three days of life can be used as a diagnostic criterion for the presence of pneumonia in children with RDS.
Key words: newborns, respiratory distress syndrome, pneumonia, immune status, presepsin.
1. Hooven TA, Polin RA. Pneumonia. Semin Fetal Neonatal Med. 2017 Aug;22(4):206-213. doi: http://dx.doi.org/10.1016/j.siny.2017.03.002
2. Costa S, Rocha G, Leitão A, Guimarães H. Transient tachypnea of the newborn and congenital pneumonia: a comparative study. J Matern Fetal Neonatal Med. 2012 Jul;25(7):992-4. doi: http://dx.doi.org/10.3109/14767058.2011.604366
3. Ruth A, McCracken CE, Fortenberry JD, Hall M, Simon HK, Hebbar KB. Pediatric severe sepsis: current trends and outcomes from the pediatric health information systems database. Pediatr Crit Care Med. 2014 Nov;15(9):828-38. doi: http://dx.doi.org/10.1097/PCC.0000000000000254
4. Stubljar D, Kopitar AN, Groselj-Grenc M, Suhadolc K, Fabjan T, Skvarc M. Diagnostic accuracy of presepsin (sCD14-ST) to predict bacterial infection measured in cerebrospinal fluid in children with suspected bacterial meningitis ventriculitis. J Clin Microbiol. 2015 Apr;53(4):1239-44. doi: http://dx.doi.org/10.1128/JCM.03052-14
5. Bas S, Gauthier BR, Spenato U, Stingelin S, Gabay C. CD14 is an acute-phase protein. J Immunol. 2004 Apr;172(7):4470-9. doi: http://dx.doi.org/10.4049/jimmunol.172.7.4470
6. Chenevier-Gobeaux C, Borderie D, Weiss N, Mallet-Coste T, Claessens Y-E. Presepsin (sCD14-ST), an innate immune response marker in sepsis. Clin Chim Acta. 2015 Oct;450:97-103. doi: http://dx.doi.org/10.1016/j.cca.2015.06.026
7. Endo S, Suzuki Y, Takahashi G, Shozushima T, Ishikura H, Murai A, et al. Usefulness of presepsin in the diagnosis of sepsis in a multicenter prospective study. J Infect Chemother. 2012 Dec;18(6):891-7. doi: http://dx.doi.org/10.1007/s10156-012-0435-2
8. Ulla M, Pizzolato E, Lucchiari M, Loiacono M, Soardo F, Forno D, et al. Diagnostic and prognostic value of presepsin in the management of sepsis in the emergency department: a multicenter prospective study. Crit Care. 2013 Jul;17(4):R168. doi: http://dx.doi.org/10.1186/cc12847
9. Pugni L, Pietrasanta C, Milani S, Vener C, Ronchi A, Falbo M, et al. Presepsin (soluble CD14 subtype): reference ranges of a new sepsis marker in term and preterm neonates. PLoS One. 2015 Dec;10(12):e0146020. doi: http://dx.doi.org/10.1371/journal.pone.0146020
10. Iskandar A, Arthamin MZ, Indriana K, Anshory M, Hur M, Di Somma S, et al. Comparison between presepsin and procalcitonin in early diagnosis of neonatal sepsis. J Matern Fetal Neonatal Med. 2019 Dec;32(23):3903-3908. doi: http://dx.doi.org/10.1080/14767058.2018.1475643
11. Poggi C, Bianconi T, Gozzini E, Generoso M, Dani C. Presepsin for the detection of late-onset sepsis in preterm newborns. Pediatrics. 2015 Jan;135(1):68-75. doi: http://dx.doi.org/10.1542/peds.2014-1755
12. Montaldo P, Rosso R, Santantonio A, Chello G, Giliberti P. Presepsin for the detection of early-onset sepsis in preterm newborns. Pediatr Res. 2017 Feb;81(2):329-334. doi: http://dx.doi.org/10.1038/pr.2016.217
13. Levy O. Innate immunity of the newborn: basic mechanisms and clinical correlates. Nat Rev Immunol. 2007 May;7(5):379-90. doi: http://dx.doi.org/10.1038/nri2075
14. Kollmann TR, Kampmann B, Mazmanian SK, Marchant A, Levy O. Protecting the Newborn and Young Infant from Infectious Diseases: Lessons from Immunе Ontogeny. Immunity. 2017 Mar;46(3):350-363. doi: http://dx.doi.org/10.1016/j.immuni.2017.03.009
15. Novikov DK, Novikov PD. Clinical immunopathology: rukovodstvo. Moscow, RF: Med lit; 2009. 448 р. (In Russ.)
16. Honda T, Uehara T, Matsumoto G, Arai S, Sugano M. Neutrophil left shift and white blood cell count as markers of bacterial infection. Clin Chim Acta. 2016 Jun;457:46-53. doi: http://dx.doi.org/10.1016/j.cca.2016.03.017
Information about authors:
Zhuravleva L.N. – Candidate of Medical Sciences, associate professor of the Chair of Pediatrics, Vitebsk State Order of Peoples’ Friendship Medical University;
Novikova V.I. – Doctor of Medical Sciences, professor, head of the Chair of Pediatrics of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University.