Role of Presepsin in Predicting ShortTerm Patient’s Status Changes and Preventing Excessive Antimicrobial Therapy in Patients with Nosocomial Infections

Abstract

Relationship between presepsin values and shortterm status of patients with infections, as well as a correlation of presepsin levels and other markers of systemic inflammatory response were analyzed in this prospective observational study. The study included patients with different types of nosocomial infections receiving empiric antimicrobial therapy. Analysis of laboratory values was performed at different time-points at the discretion of treating physician. Laboratory values were the following: presepsin (using «Pathfast® presepsin» assay), procalcitonin, C-reactive protein, total white blood cells, neutrophils, and band forms of neutrophils. Changes in patient’s clinical status in the first 3 days after analysis and patient deaths from infections in the first week after analysis were evaluated retrospectively. Data were analyzed as nonparametric values; correlation analysis was performed using Spearman test; mean values were compared using the Mann-Whitney test. A total of 71 measurements from 38 patients were analyzed. Presepsin levels (1365 pg/ ml) were significantly increased in patients with clinical worsening in the first 3 days compared to 440 pg/ml in patients without worsening (p<0.0001). Corresponding procalcitonin levels were 2.67 ng/ml and 0.43 ng/ml (p<0.001). Presepsin and procalcitonin values had significant moderate correlation (Spearman r = 0.43, p=0.002). Presepsin levels promptly predicted short-term changes in status of patients with nosocomial infections in the majority cases.