Prognostic value of presepsin (soluble CD14-subtype) in diagnosis of ventilator-associated pneumonia and sepsis in trauma patients
Background/Aim. Presepsin (soluble CD14-subtype) is a fragment of CD14 produced in response to bacterial infections and a novel biomarker of pneumonia, sepsis and septic shock. The aim of this study was to compare sensitivity and specificity of persepsin, soluble CD14-subtype (sCD14-ST) with other b...
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2018-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501700027J.pdf |
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| author | Jovanović Bojan Đurić Olivera Marković-Denić Ljiljana Isaković Aleksandra Doklestić Krstina Stanković Sanja Vidičević Sašenka Palibrk Ivan Samardžić Janko Bumbaširević Vesna |
| author_facet | Jovanović Bojan Đurić Olivera Marković-Denić Ljiljana Isaković Aleksandra Doklestić Krstina Stanković Sanja Vidičević Sašenka Palibrk Ivan Samardžić Janko Bumbaširević Vesna |
| author_sort | Jovanović Bojan |
| collection | DOAJ |
| description | Background/Aim. Presepsin (soluble CD14-subtype) is a fragment of CD14 produced in response to bacterial infections and a novel biomarker of pneumonia, sepsis and septic shock. The aim of this study was to compare sensitivity and specificity of persepsin, soluble CD14-subtype (sCD14-ST) with other biomarkers: procalcitonine (PCT), C-reactive protein (CRP) and leukocyte count (Le) in mechanically ventilated injured patients, as a marker of pneumonia, sepsis and septic shock. Methods. The prospective study was undertaken in trauma and surgery intensive care unit of the Emergency Center, the Clinical Center of Serbia from January to April 2013. The study included 39 trauma patients requiring mechanical ventilation, and who developed one of the following inclusion criteria: Systemic Inflammatory Response Syndrome (SIRS), ventilator associated pneumonia (VAP), sepsis and/or septic shock. On admission Acute Physiology and Chronic Health Evaluation II (APACHE II) Score and Injury Severity Score (ISS) were calculated. Seventy-two measurements of four biomarkers (presepsin, PCT, CRP and Le) were performed in 39 patients at the moments of diagnosis of SIRS, VAP, sepsis and/or septic shock (21 when SIRS diagnosis was established, 21 after the diagnosis of VAP, 18 at the moment of diagnosis of sepsis and the remaining 12 measurements were conducted while diagnosing the septic shock). The Sequential Organ Failure Assessment (SOFA) score was calculated at these points as well. Results. Patients were mainly severely injured (mean ISS = 24.2) and had moderately severe medical condition at admission (mean Apache II score, 14.5). Presepsin concentration significantly differed among all the four groups, except between sepsis and septic shock. The strongest positive correlation of presepsin evinced with PCT (r = 0.741, p < 0.001). The sCD14-ST indicated better performance in diagnosis of both VAP (AUC = 0.909) and sepsis (AUC = 0.899), compared to PCT (AUCs: 0.863, 0.885, respectively), CRP (AUCs: 0.703, 0.677, respectively) and Le (AUCs: 0.668, 0.700, respectively). Conclusion. This study revealed that sCD14-ST is a reliable biomarker for distinguishing sepsis severity. It also showed a good correlation with the infection development as well as worsening in injured patients. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no.175046] |
| format | Article |
| id | doaj-art-d3e263a491ff4f73a77e3eefeca42d2c |
| institution | OA Journals |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-d3e263a491ff4f73a77e3eefeca42d2c2025-08-20T02:03:41ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202018-01-01751096897710.2298/VSP161104027J0042-84501700027JPrognostic value of presepsin (soluble CD14-subtype) in diagnosis of ventilator-associated pneumonia and sepsis in trauma patientsJovanović Bojan0Đurić Olivera1Marković-Denić Ljiljana2Isaković Aleksandra3Doklestić Krstina4Stanković Sanja5Vidičević Sašenka6Palibrk Ivan7Samardžić Janko8Bumbaširević Vesna9Faculty of Medicine, Belgrade + Clinical Center of Serbia, Center for Anaesthesiology, BelgradeFaculty of Medicine, Belgrade + Institute of Epidemiology, BelgradeFaculty of Medicine, Belgrade + Institute of Epidemiology, BelgradeFaculty of Medicine, Belgrade + Institute of Medical and Clinical Biochemistry, Institute of Pharmacology, BelgradeFaculty of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Emergency Surgery, BelgradeClinical Center of Serbia, Center for Medical Biochemistry, BelgradeFaculty of Medicine, Belgrade + Institute of Medical and Clinical Biochemistry, Institute of Pharmacology, BelgradeFaculty of Medicine, Belgrade + Clinical Center of Serbia, Center for Anaesthesiology, BelgradeFaculty of Medicine, Clinical Pharmacology and Toxicology, BelgradeFaculty of Medicine, Belgrade + Clinical Center of Serbia, Center for Anaesthesiology, BelgradeBackground/Aim. Presepsin (soluble CD14-subtype) is a fragment of CD14 produced in response to bacterial infections and a novel biomarker of pneumonia, sepsis and septic shock. The aim of this study was to compare sensitivity and specificity of persepsin, soluble CD14-subtype (sCD14-ST) with other biomarkers: procalcitonine (PCT), C-reactive protein (CRP) and leukocyte count (Le) in mechanically ventilated injured patients, as a marker of pneumonia, sepsis and septic shock. Methods. The prospective study was undertaken in trauma and surgery intensive care unit of the Emergency Center, the Clinical Center of Serbia from January to April 2013. The study included 39 trauma patients requiring mechanical ventilation, and who developed one of the following inclusion criteria: Systemic Inflammatory Response Syndrome (SIRS), ventilator associated pneumonia (VAP), sepsis and/or septic shock. On admission Acute Physiology and Chronic Health Evaluation II (APACHE II) Score and Injury Severity Score (ISS) were calculated. Seventy-two measurements of four biomarkers (presepsin, PCT, CRP and Le) were performed in 39 patients at the moments of diagnosis of SIRS, VAP, sepsis and/or septic shock (21 when SIRS diagnosis was established, 21 after the diagnosis of VAP, 18 at the moment of diagnosis of sepsis and the remaining 12 measurements were conducted while diagnosing the septic shock). The Sequential Organ Failure Assessment (SOFA) score was calculated at these points as well. Results. Patients were mainly severely injured (mean ISS = 24.2) and had moderately severe medical condition at admission (mean Apache II score, 14.5). Presepsin concentration significantly differed among all the four groups, except between sepsis and septic shock. The strongest positive correlation of presepsin evinced with PCT (r = 0.741, p < 0.001). The sCD14-ST indicated better performance in diagnosis of both VAP (AUC = 0.909) and sepsis (AUC = 0.899), compared to PCT (AUCs: 0.863, 0.885, respectively), CRP (AUCs: 0.703, 0.677, respectively) and Le (AUCs: 0.668, 0.700, respectively). Conclusion. This study revealed that sCD14-ST is a reliable biomarker for distinguishing sepsis severity. It also showed a good correlation with the infection development as well as worsening in injured patients. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no.175046]http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501700027J.pdfpresepsin protein, humanpneumonia, ventilator associatedsepsisshock septicbiomarkerssensitivity and specificitydiagnosis |
| spellingShingle | Jovanović Bojan Đurić Olivera Marković-Denić Ljiljana Isaković Aleksandra Doklestić Krstina Stanković Sanja Vidičević Sašenka Palibrk Ivan Samardžić Janko Bumbaširević Vesna Prognostic value of presepsin (soluble CD14-subtype) in diagnosis of ventilator-associated pneumonia and sepsis in trauma patients Vojnosanitetski Pregled presepsin protein, human pneumonia, ventilator associated sepsis shock septic biomarkers sensitivity and specificity diagnosis |
| title | Prognostic value of presepsin (soluble CD14-subtype) in diagnosis of ventilator-associated pneumonia and sepsis in trauma patients |
| title_full | Prognostic value of presepsin (soluble CD14-subtype) in diagnosis of ventilator-associated pneumonia and sepsis in trauma patients |
| title_fullStr | Prognostic value of presepsin (soluble CD14-subtype) in diagnosis of ventilator-associated pneumonia and sepsis in trauma patients |
| title_full_unstemmed | Prognostic value of presepsin (soluble CD14-subtype) in diagnosis of ventilator-associated pneumonia and sepsis in trauma patients |
| title_short | Prognostic value of presepsin (soluble CD14-subtype) in diagnosis of ventilator-associated pneumonia and sepsis in trauma patients |
| title_sort | prognostic value of presepsin soluble cd14 subtype in diagnosis of ventilator associated pneumonia and sepsis in trauma patients |
| topic | presepsin protein, human pneumonia, ventilator associated sepsis shock septic biomarkers sensitivity and specificity diagnosis |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501700027J.pdf |
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