The value of serum presepsin in differentiating Gram-negative bacteria from Gram-positive bacteria and fungal infection in sepsis patients / 中华急诊医学杂志

ABSTRACT

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 (AUC0.866 vs 0.809).Conclusions In contrast to PCT,presepsin is a good discriminative biomarker in different infections.