Role of Presepsin and Comparison with Conventional Markers for Early Diagnosis and Differentiation of Sepsis

Faraz Hassan Mirza, Faraz Ahmed Baig, Serajuddaula Syed, Ashok Kumar, Moazzam Ali Shahid


Sepsis is a fatal condition that contributes to most deaths in health care setups worldwide. Early diagnosis of sepsis could alleviate this growing mortality rate. However, it remained a challenging task due to the lack of specific biomarkers. This study aimed to analyze the utility of novel Presepsin to indicate the early onset of sepsis and distinguish it from systemic inflammatory response syndrome compared to conventional markers. We have conducted a cross-sectional study on 38 patients who recently developed septicemia and 90 systemic inflammatory syndrome cases. Demographic data and results of initial laboratory workup for sepsis, blood culture, procalcitonin, and C-reactive protein were obtained for comparison. The plasma levels of Presepsin were significantly higher in the sepsis patients (p<0.001) with the highest sensitivity (81.6%), specificity (70%), and area under the curve (0.87). Strong statistical association of C-reactive protein and sepsis was determined despite lower validity and area under the curve. Relatively lower validity indices and receiver operating curve were found for procalcitonin, while culture appeared to be the least effective marker for early diagnosis of sepsis. Conclusively, the study showed that Presepsin could serve as a new biomarker for sepsis. Hence, we recommend revision in current management guidelines of sepsis for inclusion of Presepsin to already existing biomarkers for accurate early diagnosis and differentiation of sepsis.


Keywords: sepsis, systemic inflammatory response syndrome, soluble CD14-subtype, presepsin.

Full Text:



SPRUNG CL, SCHEIN RM, & BALK RA. The new sepsis consensus definitions: the good, the bad and the ugly. Intensive Care Medicine, 2016, 42: 2024–2026.

BERG D, & GERLACH HJF. Recent advances in understanding and managing sepsis. F1000Research, 2018, 7, F1000 Faculty Rev-1570, doi:10.12688/f1000research.15758.1.

KONDO Y, UMEMURA Y, HAYASHIDA K, et al. Diagnostic value of procalcitonin and presepsin for sepsis in critically ill adult patients: a systematic review and meta-analysis. Journal of Intensive Care, 2019, 7(1): 22.

LIMONGI D, D'AGOSTINI C, CIOTTI M. New sepsis biomarkers. Asian Pacific Journal of Tropical Biomedicine, 2016, 6(6): 516-519.

EL-SHAFIE ME-S, TAEMA KM, EL-HALLAG MM, KANDEEL A. Role of presepsin compared to C-reactive protein in sepsis diagnosis and prognostication. The Egyptian Journal of Critical Care Medicine, 2017; 5(1): 1-12.

DRAGOESCU AN, PADUREANU V, STANCULESCU AD, et al. Presepsin as a potential prognostic marker for sepsis according to actual practice guidelines. Journal of Personalized Medicine, 2021;11(1):2.

KORBER F, ZELLER I, GRÜNSTÄUDL M, et al. SeptiFast versus blood culture in clinical routine–A report on 3 years experience. Wiener klinische Wochenschrift, 2017, 129(11): 427-434.

SINGER M, DEUTSCHMAN CS, SEYMOUR CW, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA, 2016, 315(8): 801-810.

Rogić D, Juroš GF, Petrik J, Vrančić A. Advances and pitfalls in using laboratory biomarkers for the diagnosis and management of sepsis. e-Journal of the International Federation of Clinical Chemistry and Laboratory Medicine, 2017, 28(2): 114-121.

KONDO Y, UMEMURA Y, HAYASHIDA K, et al. Diagnostic value of procalcitonin and presepsin for sepsis in critically ill adult patients: a systematic review and meta-analysis. Journal of Intensive Care, 2019, 7(1): 1-13.

ALIU-BEJTA A, ATELJ A, KURSHUMLIU M, et al. Presepsin values as markers of severity of sepsis. Internayional Journal of Infectious Diseases, 2020, 95: 1-7.

DE GUADIANA ROMUALDO LG, TORRELLA PE, ACEBES SR, et al. Diagnostic accuracy of presepsin (sCD14-ST) as a biomarker of infection and sepsis in the emergency department. Clinica Chimica Acta; International Journal of Clinical Chemistry, 2017, 464: 6-11.

SHOZUSHIMA T, TAKAHASHI G, MATSUMOTO N, et al. Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome. Journal of Infection and Chemotherapy, 2011, 17(6): 764-769.

ULLA M, PIZZOLATO E, LUCCHIARI M, et al. Diagnostic and prognostic value of presepsin in the management of sepsis in the emergency department: a multicenter prospective study. Critical Care (London, England), 2013, 17(4): 1-8.

YOON SH, KIM EH, KIM HY, & AHN JG. Presepsin as a diagnostic marker of sepsis in children and adolescents: A systemic review and meta-analysis. BMC Infectious Diseases, 2019, 19(1): 1-11.

ZHANG H, WANG X, ZHANG Q, et al. Comparison of procalcitonin and high-sensitivity C-reactive protein for the diagnosis of sepsis and septic shock in the oldest old patients. BMC Geriatrics, 2017, 17(1): 1-6.

LIN C-T, LU J-J, CHEN Y-C, et al. Diagnostic value of serum procalcitonin, lactate, and high-sensitivity C-reactive protein for predicting bacteremia in adult patients in the emergency department. PeerJ, 2017, 5: e4094.

YU L, WEIZE Y, JIE W. Guiding effect of serum procalcitonin (PCT) on the antibiotic application to patients with sepsis. Iranian Journal of Public Health, 2017, 46(11): 1535.

QI Y-Z. Prognostic values of serum procalcitonin level and pediatric critical illness score in children with sepsis. Chinese Journal of Contemporary Pediatrics, 2014, 16(2): 190-193.

CUI N, ZHANG H, CHEN Z, & YU Z. Prognostic significance of PCT and CRP evaluation for adult ICU patients with sepsis and septic shock: retrospective analysis of 59 cases. The Journal of International Medical Research, 2019, 47(4): 1573-1579.

YOUSEF AAA-M, AMR YM, SULIMAN GA. The diagnostic value of serum leptin monitoring and its correlation with tumor necrosis factor-α in critically ill patients: a prospective observational study. Critical Care (London, England), 2010, 14(2): 1-9.

SWEENEY TE, LIESENFELD O, & MAY L. Diagnosis of bacterial sepsis: why are tests for bacteremia not sufficient? Expert Review of Molecular Diagnostics, 2019, 19(11): 959-962.

CANTEY JB, & BAIRD SD. Ending the culture of culture-negative sepsis in the neonatal ICU. Pediatrics, 2017, 140(4): e20170044.

LU B, ZHANG Y, LI C, et al. The utility of presepsin in diagnosis and risk stratification for the emergency patients with sepsis. The American Journal of Emergency Medicine, 2018, 36(8): 1341-1345.

ROEST AA, STOFFERS J, PIJPERS E, et al. Ambulance patients with nondocumented sepsis have a high mortality risk: a retrospective study. European Journal of Emergency Medicine, 2017, 24(1): 36-43.

DEWITT S, CHAVEZ SA, PERKINS J, et al. Evaluation of fever in the emergency department. The American Journal of Emergency Medicine, 2017, 35(11): 1755-1758.


  • There are currently no refbacks.