title: Plasmatic presepsin (sCD14-ST) concentrations in acute pyelonephritis in adult patients.
abstract: BACKGROUND
  Presepsin (sCD14-ST) is an emerging biomarker for infection. We hypothesized that presepsin could specifically increase during acute pyelonephritis and correlate with severity.
  
  
  METHODS
  We compared presepsin values in patients with acute pyelonephritis and controls, and we assessed its capacity to predict bacteraemia and admission in patients.
  
  
  RESULTS
  In 312 patients with acute pyelonephritis (median age 33years), presepsin concentrations were higher than in controls (476 vs 200ng/L, p<0.001). ROC curve indicated an AUC at 0.90 [for presepsin (vs. 0.99 and 0.98 for CRP and PCT, respectively; p<0.05) and an optimal threshold at 340ng/L (74% sensitivity, 94% specificity). Presepsin concentrations increased in acute pyelonephritis patients with bacteraemia (614 vs. 461ng/L, p,=0.001) and in those requiring admission (614ng/L vs. 320ng/L, p<0.001). Performance of presepsin to predict bacteraemia [AUC=0.63, 95%CI: 0.55-0.72] was similar to CRP (AUC=0.64, p=0.87) and less accurate than PCT (AUC=0.78, p<0.001). AUC for presepsin to detect the need for admission was 0.67, and comparable to CRP (p=0.26) and PCT (p=0.18).
  
  
  CONCLUSIONS
  Presepsin is a valuable biomarker to detect patients with acute pyelonephritis. However, it presents mild performance to predict bacteraemia and the need for admission, and offers no advantage as compared to CRP and PCT.
authors.affiliation: Centre Hospitalier Princesse Grace, Department of Emergency Medicine, 1 avenue Pasteur BP489 MC-98012, Monaco; Hôpital Cochin, Hôpitaux Universitaires Paris Centre (HUPC), Assistance Publique des Hôpitaux de Paris (AP-HP). Department of Emergency Medicine, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France.
authors.forename: Yann-Erick
authors.initials: YE
authors.lastname: Claessens
authors.affiliation: Hôpital Cochin, Hôpitaux Universitaires Paris Centre (HUPC), Assistance Publique des Hôpitaux de Paris (AP-HP). Department of Emergency Medicine, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France; Faculté de Médecine, Université Paris Descartes, 10 rue de l'école de médecine, 75006 Paris, France.
authors.forename: Eloise
authors.initials: E
authors.lastname: Trabattoni
authors.affiliation: Hôpital Hôtel-Dieu, Hôpitaux Universitaires Paris Centre (HUPC), Assistance Publique des Hôpitaux de Paris (AP-HP), Department of Biostatistics and Epidemiology, 1, place du Parvis de Notre-Dame, 75181 Paris Cedex 04, France; Faculté de Médecine, Université Paris Descartes, 10 rue de l'école de médecine, 75006 Paris, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Grabar
authors.affiliation: Hôpital Hôtel-Dieu, Hôpitaux Universitaires Paris Centre (HUPC), Assistance Publique des Hôpitaux de Paris (AP-HP), Department of Biostatistics and Epidemiology, 1, place du Parvis de Notre-Dame, 75181 Paris Cedex 04, France; Faculté de Médecine, Université Paris Descartes, 10 rue de l'école de médecine, 75006 Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Quinquis
authors.affiliation: Hôpital Cochin, Hôpitaux Universitaires Paris Centre (HUPC), Assistance Publique des Hôpitaux de Paris (AP-HP). Department of Emergency Medicine, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Der Sahakian
authors.affiliation: Hôpital Cochin, Hôpitaux Universitaires Paris Centre (HUPC), Assistance Publique des Hôpitaux de Paris (AP-HP), Department of Automated Biological Diagnosis, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Anselmo
authors.affiliation: Hôpital d'Estaing, Department of Emergency Medicine, 58 rue Montalembert, 63003 Clermont-Ferrand Cedex 1, France.
authors.forename: Jeannot
authors.initials: J
authors.lastname: Schmidt
authors.affiliation: Hôpital Caremeau, Department of Anaesthesiology, Emergency Medicine and Pain Management, Place Robert Debré, 31000 Nîmes, France.
authors.forename: Jean-Emmanuel
authors.initials: JE
authors.lastname: de la Coussaye
authors.affiliation: Hôpital Lariboisière, Groupe Hospitalier Saint-Louis Lariboisière Fernand-Widal, Assistance Publique des Hôpitaux de Paris (AP-HP), Department of Emergency Medicine, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Plaisance
authors.affiliation: Hôpital Bichat-Claude Bernard, Hôpitaux Universitaires Paris-Nord Val-de-Seine (HUPNVS), Assistance Publique des Hôpitaux de Paris (AP-HP), Department of Emergency Medicine, Rue Henri Huchard, 75651 Paris Cedex 13, France; Faculté de Médecine, Université René Diderot, 10 rue de Valmy, 75011 Paris, France.
authors.forename: Enrique
authors.initials: E
authors.lastname: Casalino
authors.affiliation: Hôtel-Dieu, Department of Emergency Medicine, 1 place Alexis-Ricordeau, 44093, Nantes, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Potel
authors.affiliation: Hôpital Cochin, Hôpitaux Universitaires Paris Centre (HUPC), Assistance Publique des Hôpitaux de Paris (AP-HP). Department of Emergency Medicine, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France.
authors.forename: François
authors.initials: F
authors.lastname: Lecomte
authors.affiliation: Hôpital Cochin, Hôpitaux Universitaires Paris Centre (HUPC), Assistance Publique des Hôpitaux de Paris (AP-HP), Department of Automated Biological Diagnosis, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France; Paris Descartes University, Sorbonne Paris Cité University, University Paris Descartes UMR-S 1124 INSERM, Paris, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Borderie
authors.affiliation: Hôpital Cochin, Hôpitaux Universitaires Paris Centre (HUPC), Assistance Publique des Hôpitaux de Paris (AP-HP), Department of Automated Biological Diagnosis, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France. Electronic address: camille.gobeaux@aphp.fr.
authors.forename: Camille
authors.initials: C
authors.lastname: Chenevier-Gobeaux
mesh_terms: D000208:Acute Disease; D000328:Adult; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011704:Pyelonephritis / Q000097:blood* / Q000150:complications; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D018950:Lipopolysaccharide Receptors; D010446:Peptide Fragments; C000594167:presepsin protein, human
keywords: Biomarkers; C-reactive protein; Emergency medicine; Presepsin; Procalcitonin; Urinary tract infection