Soluble CD14 (Presepsin) in the early prediction of bacterial type in Early Onset Neonatal Sepsis in Preterm Neonates

Background: Identifying the type of bacterial infection in a timely manner is crucial for the successful treatment of newborns with early-onset sepsis. However, blood culture results are often delayed, highlighting the urgent need for an early biomarker to predict the causative organism. Presepsin (P-SEP) has recently gained attention as a promising biomarker, generated as a component of the immune system's reaction to bacterial infection. It acts as an early warning sign of sepsis in newborns and can be identified in the first phases of inflammation. Purpose: to assess the predictive efficacy of soluble CD14 (presepsin) in identifying the type of bacterial organism in preterm newborns with early onset neonatal sepsis. Methods: thirty-six newborns with risk factors for early-onset sepsis were included in this prospective observational study, and initial CRP negative, they were further subdivided into probable & proven sepsis, based on the initial blood culture results. Serum presepsin levels, CRP and blood culture analyses were performed on all neonates. Results: Patients with gram-negative infections had significantly elevated P-SEP levels initially on the first day and at follow-up on the third day. At a cutoff value of ≥ 970 ng/L, serum P-SEP on day 3 yielded a 100% positive predictive value, an 87.5% sensitivity, a 100% specificity, and an 88.8% negative predictive value to predict gram negative bacterial infection Conclusion: Presepsin evaluation in preterm neonates with early-onset sepsis serves as a valuable early marker for identifying the type of bacterial infection present.