Presepsin and fetuin-A dyad for the diagnosis of proven sepsis in preterm neonates

Abstract

Abstract Background Diagnosis is the most strenuous step in the evaluation of neonatal sepsis. No gold standard diagnostic method is available except for blood culture. We aimed to investigate the role of positive and negative acute phase reactants, namely presepsin and fetuin-A, in the diagnosis of culture-proven late-onset sepsis. Methods A prospective, case-control study with the infants ≤32 weeks of age with a diagnosis of culture-proven late-onset sepsis was designed. Twenty-nine preterm infants with similar gestational and postnatal ages without sepsis constituted the control group. Serum values of presepsin, fetuin-A, C-reactive protein and interleukin-6 were evaluated at the enrollment, third and seventh days of the diagnosis in the infants with positive blood culture results. Results First-day presepsin values were significantly higher in the culture-positive infants than the control group [1583 ng/L (1023–1731) vs. 426 ng/L (287–589), p = 0.05). Conclusion Presepsin may be an accurate marker for both diagnosis and monitoring of treatment response for culture-proven late-onset sepsis in preterm infants. However, fetuin-A does not seem to be a useful tool for the diagnosis of sepsis.

Keywords

• Presepsin
• Neonatal sepsis
• Diagnosis