title: Presepsin for the detection of early-onset sepsis in preterm newborns.
abstract: Early-onset sepsis (EOS) is responsible for an important fraction of neonatal morbidity and mortality all over the world. The aim of this study was to assess whether presepsin (P-SEP) can be a more accurate biomarker of EOS compared with pro-calcitonin (PCT) and C-reactive protein (CRP).
  
  
  
  Consecutive preterm neonates (<34 wk gestational age, admitted to Neonatal Intensive Care Unit by 6 h of age and undergoing sepsis evaluation) were recruited as part of a case-matched control study. We determined CRP, PCT and P-SEP at admission, and then at 12, 24, and 48 h of age. Neonates recruited into the study were divided into the EOS group (n = 32) and the uninfected group (n =38) according to their infection screening.
  
  
  
  P-SEP values were significantly higher in the EOS group than in the uninfected group at different time intervals. The highest accuracy was achieved by P-SEP at 24 h after birth. The AUC for P-SEP was 0.97. In our sample, P-SEP achieved the best accuracy for prediction of EOS at the cut-off of 788 ng/l with 93% sensitivity and 100% specificity.
  
  
  
  This study shows that P-SEP is significantly higher in preterm infants with EOS compared with uninfected infants.
authors.affiliation: Department of Neonatal Intensive Care, Monaldi Hospital, Naples, Italy.|Centre for Perinatal Neuroscience, Imperial College London, London, UK.
authors.forename: Paolo
authors.initials: P
authors.lastname: Montaldo
authors.affiliation: Department of Neonatal Intensive Care, Monaldi Hospital, Naples, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Rosso
authors.affiliation: Department of Neonatal Intensive Care, Monaldi Hospital, Naples, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Santantonio
authors.affiliation: Department of Neonatal Intensive Care, Monaldi Hospital, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Chello
authors.affiliation: Department of Neonatal Intensive Care, Monaldi Hospital, Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Giliberti
mesh_terms: D017668:Age of Onset; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal; D007558:Italy; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D008297:Male; D010343:Patient Admission; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors / Q000097:blood; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis*; D013997:Time Factors
chemical_list: D015415:Biomarkers; D018950:Lipopolysaccharide Receptors; D010446:Peptide Fragments; D011498:Protein Precursors; C000594167:presepsin protein, human; D002116:Calcitonin; D002097:C-Reactive Protein