تقييم البريسبسين , الكالبروتكتين والمسببات البكتيرية للمرضى البالغين في الحالات الحرجة من تسمم الدم

Assessment of Presepsin, Calprotectin & Bacterial causes in critically ill adult patients with sepsis

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. It had very high morbidity and mortality rates and is a public health problem worldwide.
Sepsis was characterized as a systemic inflammatory response syndrome (SIRS) to infection, with three levels of severity: sepsis, severe sepsis, and septic shock. Many inflammatory markers were investigated in sepsis with different diagnostic utility as C.reactive protein & Procalcitonin. Presepsin and calprotectin are new markers which are not studied in Iraq.
Different pathogens could be associated with sepsis development as fungi, viruses, parasites and bacteria. Knowing the responsible pathogen of sepsis is fundamental for subsequent management approach.
The aim of the study is to evaluate the serum levels of Presepsin & Calprotectin in patients with septicemia as well as comparing the diagnostic utility of these biomarkers to the traditional used diagnostic methods in septicemia. Also assessing the etiological pathogenic causes of septicemia.
A forty clinically diagnosed patients with adult sepsis were included in the study. The patients were (20) males and (20) females with age ranged between (17-70). In addition to 40 healthy control participants with matched age and gender for patient group. Serum levels of Presepsin & Calprotectin were measured using commercial research ELISA kits.
Calprotectin and presepsin serum levels were elevated in patients’ group compared to control with significant result for calprotectin (P=0.019, P=0.066) respectively. Presepsin show a significant diagnostic utility. Non-significant result for both biomarkers levels in sepsis subclasses: sever sepsis, septic shock & sepsis (49.75±15.7, 59.53±18.8, 36.40±8.14) respectively for calprotectin, presepsin levels in septic shock, severe sepsis &sepsis (476.62±150.7, 551.88±161.87, 137.96±30.85) respectively.
Out of the 40 enrolled subjects, 24 patients had a confirmed microbial etiology of sepsis, candida infection in one patient, gram-positive (7) and Gram-negative (16) with non-significant association with study markers levels.
Current stady showed that, both calprotectin and presepsin elevated in septic patients and presepsin could be a good biomarker with high specificity for diagnosis of sepsis. In addition, Gram negative Salmonella typhi was the most prevalent microorganism obtained from blood culture of these patients.