ABSTRACT
The clinical picture and laboratory markers of Early-onset neonatal sepsis [EONS] are nonspecific, however a variety of different molecules have been suggested as clinical biomarkers in sepsis. Presepsin [soluble CD14-subtype] has been identified as a protein whose level increases significantly in the blood of septic patients. Hepcidin, an iron homeostasis regulator, it can be used in diagnosis of neonatal sepsis. The aim of this study is to evaluate the role of new markers namely presepsin and hepcidin in diagnosis of EONS compared to CRP before and after antibiotic therapy. The study enrolled 62 neonates, 28 of them fulfilled the criteria of EONS, and 34 healthy neonates as a control group. Serum levels of presepsin, hepcidin, CRP, complete blood picture, blood gases, and serum iron parameters for all neonates and blood cultures were done for 28 of neonates with clinical picture of sepsis. Serum levels of presepsin, hepcidin, and CRP were significantly higher in neonates with sepsis than in healthy neonates. The presepsin was more sensitive and specific than hepcidin and CRP for diagnosis of EONS. After antibiotic therapy, the serum level of presepsin was dramatically decreased as compared to its pretreatment level. The same results was noted, but to a lesser degree for hepcidin and CRP. Additionally, the presepsin level was significantly correlated to blood culture results and CRP levels. Presepsin is considered a promising biomarker for early diagnosis of EONS with higher sensitivity and specificity rather than hepcidin and CRP. Its correlation to sepsis markers and response to treatment is more informative. Future large scale studies are needed to understand the role of hepcidin and presepsin in development of sepsis in other pediatric age groups