title: Diagnostic and prognostic value of soluble CD14 subtype (Presepsin) for sepsis and community-acquired pneumonia in ICU patients.
abstract: BACKGROUND
  The soluble CD14 subtype, Presepsin, appears to be an accurate sepsis diagnostic marker, but data from intensive care units (ICUs) are scarce. This study was conducted to evaluate the diagnostic and prognostic value of Presepsin in ICU patients with severe sepsis (SS), septic shock (SSh) and severe community-acquired pneumonia (sCAP).
  
  
  METHODS
  Presepsin and procalcitonin (PCT) levels were determined for patients at admission to ICU. Four groups have been differentiated: (1) absence or (2) presence of systemic inflammatory response syndrome, (3) SS or (4) SSh; and 2 groups, among the patients admitted for acute respiratory failure: absence or presence of sCAP. Biomarkers were tested for diagnosis of SS, SSh and sCAP and for prediction of ICU mortality.
  
  
  RESULTS
  One hundred and forty-four patients were included: 44 SS and 56 SSh. Plasma levels of Presepsin and PCT were significantly higher in septic than in non-septic patients and in SSh as compared to others. The sepsis diagnostic accuracy of Presepsin was not superior to that of PCT (AUC: 0.75 vs 0.80). In the 72/144 patients admitted for acute respiratory failure, the capability of Presepsin to diagnose sCAP was significantly better than PCT. Presepsin levels were also predictive of ICU mortality in sepsis and in sCAP patients.
  
  
  CONCLUSIONS
  Plasma levels of Presepsin were useful for the diagnosis of SS, SSh and sCAP and may predict ICU mortality in these patients.
authors.affiliation: Intensive Care Medicine Department, Lapeyronie University Hospital, 371, Av Doyen G. Giraud, 34295, Montpellier, France. k-klouche@chu-montpellier.fr.|PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, Montpellier, France. k-klouche@chu-montpellier.fr.
authors.forename: Kada
authors.identifier: http://orcid.org/0000-0003-1633-7700
authors.initials: K
authors.lastname: Klouche
authors.affiliation: PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, Montpellier, France.|Department of Biochemistry, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Cristol
authors.affiliation: Department of Biochemistry, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Devin
authors.affiliation: Intensive Care Medicine Department, Lapeyronie University Hospital, 371, Av Doyen G. Giraud, 34295, Montpellier, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Gilles
authors.affiliation: Department of Biochemistry, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Nils
authors.initials: N
authors.lastname: Kuster
authors.affiliation: Intensive Care Medicine Department, Lapeyronie University Hospital, 371, Av Doyen G. Giraud, 34295, Montpellier, France.
authors.forename: Romaric
authors.initials: R
authors.lastname: Larcher
authors.affiliation: Intensive Care Medicine Department, Lapeyronie University Hospital, 371, Av Doyen G. Giraud, 34295, Montpellier, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Amigues
authors.affiliation: Intensive Care Medicine Department, Lapeyronie University Hospital, 371, Av Doyen G. Giraud, 34295, Montpellier, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Corne
authors.affiliation: Intensive Care Medicine Department, Lapeyronie University Hospital, 371, Av Doyen G. Giraud, 34295, Montpellier, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Jonquet
authors.affiliation: Department of Biochemistry, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Dupuy
keywords: Community-acquired pneumonia; Diagnosis; Presepsin; Procalcitonin; Prognosis; Septic shock; Severe sepsis