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Objective:To explore the value of plasma soluble leukocyte differentiation antigen 14 subtype(Presepsin) combined with neutrophil gelatinase associated lipocalin(NGAL) in the early diagnosis and prognosis of sepsis in children.Methods:A total of 94 children with sepsis admitted to our hospital from June 2017 to October 2020 were selected, 41 children with shock were classified as septic shock group, and 53 children without shock were classified as sepsis group.Another 41 healthy children in our hospital during the same period were selected as the control group.The plasma levels of Presepsin, NGAL, procalcitonin(PCT) and C-reactive protein(CRP)were detected in three groups.The pediatric critical illness score and sequential organ failure(SOFA)score of children with sepsis were recorded.According to the mortality of the children within 28 days of admission, they were divided into survival group( n=75)and death group( n=19). The plasma levels of Presepsin, NGAL, PCT and CRP, pediatric critical illness score and SOFA score were compared between the survival group and the death group.Pearson test and receiver operating characteristic curve were used to analyze the correlation between plasma Presepsin, NGAL and pediatric critical illness score, SOFA score, and the predictive value of early diagnosis and prognosis of sepsis in children. Results:The levels of plasma Presepsin, NGAL, PCT and CRP in sepsis group and septic shock group were higher than those in control group, and those in septic shock group were higher than those in sepsis group( P<0.05). The plasma levels of Presepsin, NGAL, PCT, CRP and SOFA scores in death group were higher than those in survival group, and the pediatric critical illness score in death group was lower than that in survival group( P<0.05). Plasma Presepsin and NGAL were negatively correlated with pediatric critical illness score( r=-0.676, P<0.001; r=-0.664, P<0.001), and positively correlated with SOFA score( r=0.781, P<0.001; r=0.749, P<0.001). When the plasma Presepsin level was 468.91 ng/L, the sensitivity of area under curve(AUC) for sepsis diagnosis was 85.6% and the specificity was 77.5%.When the plasma NGAL level was 38.94 ng/mL, the sensitivity of AUC for sepsis diagnosis was 82.4%, and the specificity was 65.8%.The AUC of plasma Presepsin combined with NGAL for early diagnosis of sepsis was 0.912(95% CI 0.865 to 0.959), which was higher than of plasma Presepsin of 0.857(95% CI 0.785 to 0.928) and the AUC of NGAL of 0.761(95% CI 0.680 to 0.841). When the plasma Presepsin level was 816.92 ng/L, the sensitivity for predicting the prognosis of sepsis was 73.2% and the specificity was 76.1%.When the plasma NGAL level was 51.27 ng/mL, the sensitivity for predicting the prognosis of sepsis was 67.4% and the specificity was 68.0%.The AUC of plasma Presepsin combined with NGAL to predict the prognosis of sepsis was 0.891(95% CI 0.816 to 0.966), which was higher than the AUC of plasma Presepsin of 0.795(95% CI 0.698 to 0.892) and NGAL of AUC 0.714(95% CI 0.577 to 0.851). Conclusion:Clinical detection of plasma Presepsin and NGAL levels is helpful to early diagnosis of sepsis and judge the severity of the disease in children, which has guiding significance in evaluating the prognosis, and is beneficial to improve the prognosis.
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Objective To examine whether presepsin level can serve as a distinguishing marker between G-bacteria and G+ bacteria,fungal infection in sepsis patients.Methods A prospective observation study was conducted on the consecutive patients with positive bacterial cultures in intensive care unit (ICU) from June 2017 to November 2018.The patients were divided into the G-group,G+ group and fungal group.Blood samples were collected upon admission to measure the levels of presepsin and procalcitonin (PCT).Results (1) Of the 156 patients met the inclusion criteria.96 (62％ G-rods,25 (16％) G+ microbes,and 35 (22％) fungi were detected.(2) Presepsin concentrations were significantly higher in the G-group compared with the G+ and fungal groups (P =0.000).(3) Presepsin level has a higher accuracy in differentiating G-sepsis from Gram+ and fungal sepsis than PCT level [area under the curve (AUC):0.809 vs 0.712].The AUC value of a combination of presepsin and PCT level was significantly larger than that of presepsin level alone in differentiating G-sepsis from Gram+ and fungal sepsis (AUC:0.866 vs 0.809).Conclusions In contrast to PCT,presepsin is a good discriminative biomarker in different infections.
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Objective To assess the diagnostic and prognostic value of measuring presepsin in patients with acute respiratory distress syndrome (ARDS).Methods Plasma prsepsin was collected from 81 patients with ARDS,27 patients with cardiogenic pulmonary edema (CPE) and 20 healthy volunteers at enrollment.Levels of presepsin were measured using the PATHFAST(R) analysis system based on a chemiluminescent enzyme immunoassay (CLEIA).The differences of plasma prsepsin were compared between different groups.The 28-day mortality were followed in ARDS patients,and the characteristics of the surviors and non-surviors were compared.Results ARDS patients had significantly higher median levels of presepsin compared to CPE patients [926.89 (485.41-2 662.32)pg/mL vs.376.21 (247.16-568.52) pg/mL,P＜0.001] at enrollment.The difference between infected and non-infected ARDS patients did not showed statistical significance [(934.74 (456.44-3 322.51) pg/mL vs.798.12 (485.41-2 561.40) pg/mL,P--0.079).In ARDS patients,the presepsin levels of non-survivors was significantly higher than that of survivors [3 158.3 (963.91-4 489.33) pg/mL vs.729.09 (398.05-1 467.24) pg/mL,P＜0.001],and multivariate Logistic regression showed that presepsin (OR =1.51,P =0.027) was the independent predictor for 28-day mortality in ARDS patients with acute lung injury (ALI).Conclusions Presepsin was an effective indicator in diagnosing ARDS,and it also was a strong prognostic marker for short-term mortality in ARDS.
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Objective To compare the value of presepsin,procalcitonin (PCT) and C-reactive protein (CRP) in differentiating different types of pathogenic bacteria in septic patients.Methods A prospective study was conducted to collect 322 septic patients who met the diagnostic criteria of "sepsis 3.0"in the Emergency ICU of the First Affiliated Hospital of Dalian Medical University from July 2016 to January 2018.According to the results of blood culture,patients were divided into the positive blood culture group (n=114) and negative blood culture group (n=208).Patients in the positive blood culture group were further divided into four subgroups:Gram-positive coccus (G+),Gram-negative bacilli (G-),mixed bacteria,and fungi groups.Healthy volunteers were selected as the control group (n=45).The differences in presepsin,PCT and CRP levels were compared among the groups,and the curves of the subjects' working characteristic curve (ROC) were drawn.Results Presepsin,PCT,and CRP were significantly increased in the positive blood culture and negative blood culture groups compared with the control group (all P＜0.05);Presepsin and PCT were significantly higher in the positive blood culture group than those in the negative blood culture group (both P＜0.05).There was no significant difference in Presepsin among the four subgroups in the positive blood culture group (all P＞0.05),but PCT was significantly higher in the G-and mixed bacteria groups than that in the G+ and fungi groups (all P＜0.05).Presepsin predicted a positive blood culture with area under ROC curve of 0.680,which was higher than PCT (AUC=0.599).Conclusions Presepsin is more valuable than PCT in early predicting positive blood culture in septic patients,but only PCT has an ability to differentiate pathogenic bacteria in septic patients with positive blood culture.It suggested that a combination of Presepsin and PCT should be more meaningful in clinical practice.
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Objective@#To examine whether presepsin level can serve as a distinguishing marker between G- bacteria and G+ bacteria, fungal infection in sepsis patients.@*Methods@#A prospective observation study was conducted on the consecutive patients with positive bacterial cultures in intensive care unit (ICU) from June 2017 to November 2018. The patients were divided into the G- group, G+ group and fungal group. Blood samples were collected upon admission to measure the levels of presepsin and procalcitonin (PCT).@*Results@#(1) Of the 156 patients met the inclusion criteria. 96 (62% G- rods, 25 (16%) G+ microbes, and 35 (22%) fungi were detected. (2) Presepsin concentrations were significantly higher in the G- group compared with the G+ and fungal groups (P = 0.000). (3) Presepsin level has a higher accuracy in differentiating G- sepsis from Gram+ and fungal sepsis than PCT level [area under the curve (AUC): 0.809 vs 0.712]. The AUC value of a combination of presepsin and PCT level was significantly larger than that of presepsin level alone in differentiating G- sepsis from Gram+ and fungal sepsis (AUC: 0.866 vs 0.809).@*Conclusions@#In contrast to PCT, presepsin is a good discriminative biomarker in different infections.
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AIM To investigate the effects of Shuxuening Injection (Ginkgo biloba leaf extract) on serum lactic acid (Lac),soluble CD14-st (Presepsin) and nitric oxide synthase (NOS) levels in sepsis patients.METHODS One hundred and eight patients with sepsis treated by routine treatment in our hospital from Jan.2014 to Oct.2016 were randomly divided into two groups,control group and Shuxuening group (therapy group).Two weeks were one therapeutic course.Before the treatment (the onset of patients within 3 hours),at 6 hours and 5 days after the treatment,Lac and Presepsin levels were detected,and the changes of nitric oxide (NO),NOS,inducible nitric oxide synthase (iNOS) and sequential organ failure assessment (SOFA) score were observed.Incidence of major adverse cardiac events (MACE) and 28-day survival were recorded at the same time.RESULTS Before the treatment,there were no significant differences in SOFA score and the levels of Lac,Presepsin,NO,NOS and iNOS between the two groups (P ＞ 0.05).Six hours after the treatment,the levels of Lac and Presepsin in the therapy group were lower than those in the control group (P ＜ 0.05),both the two groups had lower levels of Lac and Presepsin than those before the treatment (P ＜ 0.05);five days after the treatment,the levels of Lac and Presepsin in the two groups were lower than those at 6 hours after the treatment (P ＜ 0.05),the levels of Lac and Presepsin in the therapy group were lower than those in the control group (P ＜ 0.05).The SOFA score,NO,NOS and iNOS levels after the treatment in the therapy group were lower than those in the control group (P ＜ 0.05).The levels of Lac and Presepsin in sepsis patients were positively correlated with SOFA score (r =0.245,0.261,P =0.011,0.006).The patients in the therapy group had lower incidence of MACE and 28-day mortality rate than those in the control group (P ＜ 0.05).CONCLUSION The therapeutic effect of Shuxuening Injection combined with routine treatment on sepsis patients is superior to that of routine treatment,which can improve the prognosis of patients to a certain extent.
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Objective To observe and evaluate the clinical value of presepsin level in cirrhosis-associated bacterial infections. Methods 30 cirrhosis patients with bacterial infections were enrolled as study group.At admission,60 cirrhosis patients without bacterial infections were enrolled as control group.The difference of blood presepsin level between two groups were analyszed and compared the relationship between level of presepsin patients.The level of presepsin of survival and death group were compared and analyszed risk factors for the prognosis of bacterial infection by COX multi-factor analysis.The sensitivity and specificity were compared by PCT,CRP and presepsin detection.Results The blood presepsin level of study group was 1 002.3(575.1 2~149.5)pg/ml,the blood presepsin level of control group was 475.0(332.7~680.2)pg/ml. The presepsin of study group was significantly higher than control group,the difference was statistically significant(t=1.865,P<0.05).The presepsin level of death patients was significantly higher than survival patients(t=5.875,P<0.05). COX multi-factor analysis showed that presepsin levels were independent risk factors affecting the prognosis of bacterial in-fection in patients with liver cirrhosis.There were statistically significant of sensitivity and specific degrees between presep-sin and CRP(P<0.05).Conclusion Presepsin level is a valuable new biomarker for defining severe infections in cirrhosis. The increase of Presepsin level can be used as a judgment is an important index indicator of liver cirrhosis bacterial infection. It was worthy of clinical attention.
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AIM To investigate the effects of Shuxuening Injection (Ginkgo biloba leaf extract) on serum lactic acid (Lac),soluble CD14-st (Presepsin) and nitric oxide synthase (NOS) levels in sepsis patients.METHODS One hundred and eight patients with sepsis treated by routine treatment in our hospital from Jan.2014 to Oct.2016 were randomly divided into two groups,control group and Shuxuening group (therapy group).Two weeks were one therapeutic course.Before the treatment (the onset of patients within 3 hours),at 6 hours and 5 days after the treatment,Lac and Presepsin levels were detected,and the changes of nitric oxide (NO),NOS,inducible nitric oxide synthase (iNOS) and sequential organ failure assessment (SOFA) score were observed.Incidence of major adverse cardiac events (MACE) and 28-day survival were recorded at the same time.RESULTS Before the treatment,there were no significant differences in SOFA score and the levels of Lac,Presepsin,NO,NOS and iNOS between the two groups (P ＞ 0.05).Six hours after the treatment,the levels of Lac and Presepsin in the therapy group were lower than those in the control group (P ＜ 0.05),both the two groups had lower levels of Lac and Presepsin than those before the treatment (P ＜ 0.05);five days after the treatment,the levels of Lac and Presepsin in the two groups were lower than those at 6 hours after the treatment (P ＜ 0.05),the levels of Lac and Presepsin in the therapy group were lower than those in the control group (P ＜ 0.05).The SOFA score,NO,NOS and iNOS levels after the treatment in the therapy group were lower than those in the control group (P ＜ 0.05).The levels of Lac and Presepsin in sepsis patients were positively correlated with SOFA score (r =0.245,0.261,P =0.011,0.006).The patients in the therapy group had lower incidence of MACE and 28-day mortality rate than those in the control group (P ＜ 0.05).CONCLUSION The therapeutic effect of Shuxuening Injection combined with routine treatment on sepsis patients is superior to that of routine treatment,which can improve the prognosis of patients to a certain extent.
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Objective To investigate the value of serum soluble leukocyte differentiation antigen 14 subtype (sCD14-ST,presepsin) combined with national early warning score (NEWS) for predicting the prognosis of emergency patients with sepsis.Methods To select 119 patients who came to the emergency department of Beijing Hospital with sepsis from September 2009 to July 2015 as the objects of the study.The serum samples were collected immediately as they came,the presepsin was measured,and the NEWS scorescalculated.Patients were divided into survival group (81 cases) and death group (38 cases) according to the 30-day prognosis,and the value of the presepsin,NEWS score and presepsin + NEWS score in the assessment of prognosis were compared.Results Presepsin and NEWS scores both were higher in the death group than the survival group.Presepsin and NEWS were the independent risk factors of the 30-day mortality of patients with sepsis.Under the ROC curve area (AUC) of presepsin and NEWS were 0.842 and 0.823;the combination of Presepsin and NEWS was 0.906.When presepsin ＞ 927.5 pg / mL and NEWS ＞ 6.5 points,it can significantly improve the efficacy of predicting prognosis.Conclusions Serum presepsin is a good indicator to judge the prognosis of patients with sepsis,and the combination with NEWS can improve the ability to predict the risk of septic death.
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Sepsis is a frequently met syndrome with complex clinical symptoms and high mortality in emergency department. Early diagnosis of sepsis and timely treatment can improve survival. In recent years, the application of biomarkers [such as procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6)] are commonly used in the early diagnosis of sepsis, but their specificity and sensitivity are limited because of the long lag of report time. Soluble leukocyte differentiation antigen 14 sub type (sCD14-ST, namely presepsin) is a kind of novel biomarkers. Presepsin has a high specificity and sensitivity in the diagnosis of sepsis. It has some value to evaluate the severity of sepsis, antibiotic treatment of antibiotics, and prognosis of the patients with sepsis, and its latest detection method is fast and accurate, so it has the feasibility of clinical application.
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Objetivo: Evaluar la capacidad diagnóstica de los biomarcadores presepsina, procalcitonina y proteína C reactiva (PCR), en pacientes sépticos de las unidades de cuidado intensivo de Santa Marta, Colombia. Materiales y métodos: Estudio de casos y controles, la determinación de biomarcadores se hizo mediante métodos analíticos. Se valoró la capacidad discriminante de los diferentes marcadores mediante el área bajo la curva ROC. Resultados: de los pacientes con diagnóstico de sepsis, 55% presentaron hemocultivos negativos y 45% positivos. En este estudio el área bajo la curva (AUC) para la presepsina fue de 0,996, para la procalcitonina de 0,709 y para la PCR de 0,607. Con un nivel de significancia de 0,05, la presepsina dio un valor p de 0,006; la procalcitonina de 0,084 y la PCR de 0,23. Conclusiones: Se determinó que la presepsina es el mejor biomarcador para el diagnóstico temprano de sepsis.
Objective: To evaluate the diagnostic ability of presepsin, procalcitonin and C-reactive protein (CRP) biomarkers in septic patients in intensive care units in Santa Marta (Colombia). Materials and Methods: Case-control studies, biomarker determination, was made by analytical methods. The discriminant ability of different markers was valued by using the area under the ROC curve. Results: Of the patients diagnosed with sepsis, 55% had negative blood cultures, and 45% were positive. In this study the area under the curve (AUC) for presepsin was 0.996; for procalcitonin was 0.709, and for CPR was 0.607. With a significance level of 0.05, presepsin showed a p-value of 0.006; procalcitonin showed a value of 0.084 and C-reactive protein showed a value of 0.23. Conclusions: It was determined that presepsin is the best biomarker for early diagnosis of sepsis.
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Objective To investigate the early diagnostic value and prognostic significance of serum presepsin in patients with sepsis.Methods A prospective observational study of 80 patients from ICU was carried out between January 2014 and June 2015.According to sepsis criteria,the cases were divided into sepsis group (n =50)and noninfectious systemic inflammation syndrome group (SIRS group,n =30), and another 25 healthy volunteers were collected as control group.Meanwhile,sepsis group was further divided into survival and death subgroups according to 28-day mortality.The dynamic changes of serum presepsin,procalcitonin (PCT),soluble myeloid cells expressing triggering receptor-1 (sTREM-1 ),C-reactive protein (CRP),interleukin 6 (IL-6)were monitored on the 1st,3rd and 7th day after admission. Results (1)The serum presepsin level of sepsis group was higher than SIRS group and control group on the 1st day,and the difference was statistically significant [912.0 (563.5,1514.8)pg/mL vs.462.0 (334.0,556.0)pg/mL vs.120.0 (70.2,320.1)pg/mL,P <0.05];(2)The area under the ROC curve (AUC)of presepsin for the sepsis diagnosis was greater than PCT,sTREM-1,CRP,IL-6.As cut-off point set at 672.5 pg/mL,presepsin measurements showed a sensitivity of 80%,specificity of 96.7%, combination of presepsin,PCT and sTREM-1 could offer better diagnostic confirmation;(3)The level of serum presepsin,PCT and sTREM-1 in death group were higher than those in survival group.The levels of serum presepsin,PCT,sTREM-1 and IL-6 in survival group gradually decreased to normal level following the therapy,but the levels of above markers in death group didn’t decrease significantly;(4)The AUC of presepsin in prognosis of sepsis prediction was greater than that of PCT,sTREM-1,and combination of the above three markers could offer better prognostic value.Conclusions Serum presepsin provided superior diagnostic and prognostic accuracy to PCT and sTREM-1,and the combination of presepsin,PCT and sTREM-1 can offer the reliable guide for sepsis diagnosis and death risk prediction.
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Sepsis remains a leading cause of death in the intensive care units and in all age groups worldwide. Early recognition and diagnosis are key to achieving improved outcomes. Therefore, novel biomarkers that might better inform clinicians treating such patients are surely needed. The main attributes of successful biomarkers would be high sensitivity, specificity, possibility of bedside monitoring and financial accessibility. A panel of sepsis biomarkers along with currently used laboratory tests will facilitate earlier diagnosis, timely treatment and improved outcome may be more effective than single biomarkers. In this review, we summarize the most recent advances on sepsis biomarkers evaluated in clinical and experimental studies.
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Sepsis is a frequent condition with high mortality,and its early diagnosis in the pediatrics department is one of the keys to improve survival. C-reactive protein and procalcitonin have been used as bio-markers in the diagnosis of sepsis,but they have limited susceptibility and specificity,and can be elevated in non inflammatory condition. Presepsin is the free fragment of a glycoprotein expressed on monocytes/macro-phages. Preliminiary reports suggest that levels of presepsin are significantly higher in septic patients com-pared to healthy individuals, and presepsin is useful for evaluating the severity of sepsis.
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Sepsis remains a leading cause of death in the intensive care units and in all age groups worldwide. Early recognition and diagnosis are key to achieving improved outcomes. Therefore, novel biomarkers that might better inform clinicians treating such patients are surely needed. The main attributes of successful biomarkers would be high sensitivity, specificity, possibility of bedside monitoring and financial accessibility. A panel of sepsis biomarkers along with currently used laboratory tests will facilitate earlier diagnosis, timely treatment and improved outcome may be more effective than single biomarkers. In this review, we summarize the most recent advances on sepsis biomarkers evaluated in clinical and experimental studies.
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Objective The present study aimed to explore the value of plasma Presepsin levels for predicting the incidence of multiple organs dysfunction (MOD) in septic patients in an emergency department (ED).Methods A prospective observational study was performed in the ED of Beijing Chao～Yang Hospital from November 2013 to October 2014.A total of 680 septic patients were consecutively enrolled.The septic patients who developed MOD or non-MOD were recorded.Plasma Presepsin and serum procalcitonin (PCT) levels were detected,and sepsis-related organ failure assessment (SOFA) score were calculated upon ED arrival.Results Plasma Presepsin levels at ED admission were significantly higher in patients with MOD [1023.5 (728.3-1 860.0) pg/mL] than in those without MOD [334.0 (218.0-479.5) pg/mL],and were not different between different types of organ dysfunction.Median Presepsin levels in septic patients with different numbers of organ dysfunction were 235.0 (172.0-340.3) pg/mL in those with no organ dysfunction,403.5 (275.8-587.3) pg/mL in those with one organ dysfunction,844.5 (559.8-1 259.5) pg/mL in those with two organs dysfunction,and 1 412.5 (893.0-2 675.8)pg/mL in those with three or more than organs dysfunction,respectively,which was statistically significant between every two groups.Presepsin,PCT and SOFA score were all the independent predictors of MOD.The areas under ROC curve (AUCs) of Presepsin for predicting MOD were 0.914,significantly higher than that of PCT (0.756) and SOFA score (0.840),respectively.Conclusions Plasma Presepsin levels were not different between different types of organ dysfunction.Presepsin levels increased with increasing numbers of organ dysfunction in septic patients,and Presepsin was superior to PCT and SOFA score in predicting the incidence of MOD.In conclusion,Presepsin was a valuable biomarker in evaluating MOD in septic patients in ED.
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Objective To investigate the clinical significance of plasma presepsin levels in patients with sepsis. Methods 92 patients who were admitted to the ICU of the affiliated hospital of Jiangsu University from October 2011 to March 2013 and 30 age-matched healthy controls were enrolled in this study. The patients were divided into three groups: sepsis, SIRS, and control. Plasma presepsin and serum procalcitonin (PCT) were measured, APACHEⅡscore were calculated at enrollment, and ROC curve was used to analyze the performance index for the diagnosis of sepsis. Results Serum levels of presepsin, PCT and APACHEⅡscore were significantly higher in the death group than in the SIRS group and the control group (P<0.01). Serum levels of presepsin and PCT were higher in the sepsis group than in the SIRS group and the control group (P<0.05). There was no significant statistical difference between the SIRS group and the sepsis group in the APACHEⅡ score (detailed in table 1). Level of plasma presepsin was significantly correlated with serum PCT (r = 0.82); plasma presepsin level was related with the APACHEⅡ score (r = 0.69). The area under the curve (AUC) of presepsin was 0.908 (95%CI 0.848~0.967), greater than the AUC of PCT 0.862 (95%CI 0.787~0.937). The cutoff value of presepsin for discrimination of bacterial and nonbacterial infectious diseases was determined to be 629 pg/mL, of which the clinical sensitivity and specificity were 68.6% and 90%, respectively; when the cutoff value of PCT was 1.98 ng/mL, the clinical sensitivity and specificity were 92%and 65%. Conclusions Level of presepsin increases in patients with sepsis, and an elevated presepsin may suggest the severity of sepsis.
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BACKGROUND:In 2004, a new biomarker sCD14-subtypes (presepsin) was found and its value was shown in the diagnosis and evaluation of sepsis. This article is a brief overview of the new biomarker. DATA SOURCES:A literature search using multiple databases was performed for articles, especially meta-analyses, systematic reviews, and randomized controlled trials. RESULTS:Compared with other markers, presepsin seems to have a better sensitivity and specificity in the diagnosis of sepsis. Presepsin as a biom1arker is not only suitable for the early diagnosis of sepsis, but also for the assessment of its severity and prognosis. CONCLUSIONS:Presepsin has a higher sensitivity and specificity in the diagnosis of sepsis as a new biomarker, and is a predictor for the prognosis of sepsis. More importantly, preseptin seems to play a crucial role as a supplemental method in the early diagnosis of sepsis. Since there is no multicenter study on the relationship between presepsin and sepsis, further studies on the clinical values of presepsin are needed.