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D’Adamo E, Peila C, Strozzi M, Barolo R, Maconi A, Nanni A, Botondi V, Coscia A, Bertino E, Gazzolo F, Abdelhameed AS, Conte M, Picone S, D’Andrea M, Lizzi M, Quarta MT, Gazzolo D. Presepsin in Human Milk Is Delivery Mode and Gender Dependent. Nutrients 2024; 16:2554. [PMID: 39125434 PMCID: PMC11313726 DOI: 10.3390/nu16152554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/15/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
Breast milk (BM) is a unique food due to its nutritional composition and anti-inflammatory characteristics. Evidence has emerged on the role of Presepsin (PSEP) as a reliable marker of early sepsis diagnosis. In the present study, we aimed to investigate the measurability of PSEP in BM according to different maturation stages (colostrum, C; transition, Tr; and mature milks, Mt) and corrected for delivery mode and gender. We conducted a multicenter prospective case-control study in women who had delivered 22 term (T) and 22 preterm (PT) infants. A total of 44 human milk samples were collected and stored at -80 °C. BM PSEP (pg/mL) levels were measured by using a rapid chemiluminescent enzyme immunoassay. PSEP was detected in all samples analyzed. Higher (p < 0.05) BM PSEP concentrations were observed in the PT compared to the T infants. According to the grade of maturation, higher (p < 0.05) levels of PSEP in C compared to Tr and Mt milks were observed in the whole study population. The BM subtypes' degrees of maturation were delivery mode and gender dependent. We found that PSEP at high concentrations supports its antimicrobial action both in PT and T infants. These results open the door to further studies investigating the role of PSEP.
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Affiliation(s)
- Ebe D’Adamo
- Neonatal Intensive Care Unit, “G. D’Annunzio” University, 66100 Chieti, Italy; (E.D.); (A.N.); (V.B.); (M.C.); (M.D.); (M.L.)
| | - Chiara Peila
- Neonatology Unit, Department of Public Health and Pediatrics, University of Turin, 10124 Torino, Italy; (C.P.); (R.B.); (A.C.); (E.B.)
| | - Mariachiara Strozzi
- Department of Pediatrics and Neonatology, Cardinal Massaia Hospital, 14100 Asti, Italy;
| | - Roberta Barolo
- Neonatology Unit, Department of Public Health and Pediatrics, University of Turin, 10124 Torino, Italy; (C.P.); (R.B.); (A.C.); (E.B.)
| | - Antonio Maconi
- Department of Maternal, Fetal and Neonatal Medicine, ASO SS Antonio, Biagio and C. Arrigo, 15121 Alessandria, Italy;
| | - Arianna Nanni
- Neonatal Intensive Care Unit, “G. D’Annunzio” University, 66100 Chieti, Italy; (E.D.); (A.N.); (V.B.); (M.C.); (M.D.); (M.L.)
| | - Valentina Botondi
- Neonatal Intensive Care Unit, “G. D’Annunzio” University, 66100 Chieti, Italy; (E.D.); (A.N.); (V.B.); (M.C.); (M.D.); (M.L.)
| | - Alessandra Coscia
- Neonatology Unit, Department of Public Health and Pediatrics, University of Turin, 10124 Torino, Italy; (C.P.); (R.B.); (A.C.); (E.B.)
| | - Enrico Bertino
- Neonatology Unit, Department of Public Health and Pediatrics, University of Turin, 10124 Torino, Italy; (C.P.); (R.B.); (A.C.); (E.B.)
| | - Francesca Gazzolo
- Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy;
| | - Ali Saber Abdelhameed
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Mariangela Conte
- Neonatal Intensive Care Unit, “G. D’Annunzio” University, 66100 Chieti, Italy; (E.D.); (A.N.); (V.B.); (M.C.); (M.D.); (M.L.)
| | - Simonetta Picone
- Neonatal Intensive Care Unit, Policlinico Casilino, 00169 Rome, Italy;
| | - Marianna D’Andrea
- Neonatal Intensive Care Unit, “G. D’Annunzio” University, 66100 Chieti, Italy; (E.D.); (A.N.); (V.B.); (M.C.); (M.D.); (M.L.)
| | - Mauro Lizzi
- Neonatal Intensive Care Unit, “G. D’Annunzio” University, 66100 Chieti, Italy; (E.D.); (A.N.); (V.B.); (M.C.); (M.D.); (M.L.)
| | - Maria Teresa Quarta
- Neonatal Intensive Care Unit, “G. D’Annunzio” University, 66100 Chieti, Italy; (E.D.); (A.N.); (V.B.); (M.C.); (M.D.); (M.L.)
| | - Diego Gazzolo
- Neonatal Intensive Care Unit, “G. D’Annunzio” University, 66100 Chieti, Italy; (E.D.); (A.N.); (V.B.); (M.C.); (M.D.); (M.L.)
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D'Adamo E, Levantini G, Librandi M, Botondi V, Di Ricco L, De Sanctis S, Spagnuolo C, Gazzolo F, Gavilanes DA, Di Gregorio P, Di Monte J, Strozzi MC, Maconi A, Cassinari M, Libener R, Gazzolo D. Fetal chronic hypoxia does not affect urinary presepsin levels in newborns at birth. Clin Chem Lab Med 2024; 62:1643-1648. [PMID: 38353160 DOI: 10.1515/cclm-2023-1308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/24/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVES Early sepsis detection and diagnosis still constitutes an open issue since the accuracy of standard-of care parameters is biased by a series of perinatal factors including hypoxia. Therefore, we aimed at investigating the effect of fetal chronic hypoxia insult on urine levels of a promising new marker of sepsis, namely presepsin (P-SEP). METHODS We conducted a prospective case-control study in 22 cases of early-intrauterine growth restriction (E-IUGR) compared with 22 small-for-gestational-age (SGA) newborns and 66 healthy controls. P-SEP urine samples were collected over the first 72 h from birth. Blood culture and C-reactive protein (CRP) blood levels were measured in E-IUGR and SGA infants. Perinatal standard monitoring parameters and main outcomes were also recorded. RESULTS No significant urinary P-SEP differences (p>0.05, for all) were observed among studied groups. Moreover, no significant correlations (p>0.05, for both) between urinary P-SEP and blood CRP levels in both E-IUGR and SGA groups (R=0.08; R=0.07, respectively) were observed. CONCLUSIONS The present results showing the lack of influence of fetal chronic hypoxia on urinary P-SEP levels offer additional data to hypothesize the possible use of urinary P-SEP measurement in neonates in daily clinical practice. Further multicenter prospective data are needed, including infants with early-onset sepsis.
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Affiliation(s)
- Ebe D'Adamo
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | | | - Michela Librandi
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | - Valentina Botondi
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | - Laura Di Ricco
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | - Sara De Sanctis
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | - Cynzia Spagnuolo
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | | | - Danilo Aw Gavilanes
- Department of Pediatrics and Neonatology, Maastricht University, Maastricht, The Netherlands
| | | | | | - Maria Chiara Strozzi
- Department of Pediatrics and Neonatology, Ospedale Cardinal Massaia, Asti, Italy
| | - Antonio Maconi
- Social Security Administration Development and Promotion of Scientific Research Unit, SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | - Maurizio Cassinari
- Department of Clinical Biochemistry, Transfusion and Regeneration Medicine Alessandria Hospital, Alessandria, Italy
| | - Roberta Libener
- Department of Clinical Biochemistry, Transfusion and Regeneration Medicine Alessandria Hospital, Alessandria, Italy
| | - Diego Gazzolo
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
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van Leeuwen LM, Fourie E, van den Brink G, Bekker V, van Houten MA. Diagnostic value of maternal, cord blood and neonatal biomarkers for early-onset sepsis: a systematic review and meta-analysis. Clin Microbiol Infect 2024; 30:850-857. [PMID: 38467246 DOI: 10.1016/j.cmi.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 02/26/2024] [Accepted: 03/04/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND An accurate diagnosis of early-onset sepsis (EOS) is challenging because of subtle symptoms and the lack of a good diagnostic tool, resulting in considerable antibiotic overtreatment. A biomarker, discriminating between infected and non-infected newborns at an early stage of the disease, could improve EOS prediction. Numerous biomarkers have been tested, but have never been compared directly. OBJECTIVES We aimed to provide a comprehensive overview of early biomarkers and their diagnostic value in maternal samples, umbilical cord blood, and neonatal serum. DATA SOURCES PubMed-Medline, EMBASE, The Cochrane Library, and Web of Science were searched up to 1 March 2023, without restrictions on publication date, population, or language. STUDY ELIGIBILITY CRITERIA Articles describing the diagnostic value of at least one biomarker in the detection of EOS in neonates, independent of gestational age, were included. ASSESSMENT OF RISK OF BIAS The QUADAS-2 tool was used to assess study quality. METHODS OF DATA SYNTHESIS Three independent researchers assessed the articles using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Meta-analysis was performed with all manuscripts describing diagnostic accuracy using a random-effects model. RESULTS Of 2296 identified articles, 171 reports were included in the systematic review and 69 in the meta-analysis. Literature showed mixed and inconsistent evidence for most biomarkers and sample types, because of a lack of a uniform EOS case definition, small sample sizes, and large heterogeneity between studies. Interesting markers were procalcitonin (pooled sensitivity 79%, 95% CI 71-84%; specificity 91%, 95% CI 83-96%, n = 11) and interleukin (IL)-6 (pooled sensitivity 83%, 95% CI 71-90%; specificity 87%, 95% CI 78-93%, n = 8) in umbilical cord blood and presepsin (pooled sensitivity 82%, 95% CI 62-93%; specificity 86%, 95% CI 73-93%, n = 3) and serum amyloid A (pooled sensitivity 92%, 95% CI 75-98%; specificity 96%, 95% CI 78-99%, n = 4) in neonatal serum. Studies on the combination of biomarkers were scarce. CONCLUSIONS A biomarker stand-alone test is currently not reliable for direct antibiotic stewardship in newborns, although several biomarkers show promising initial results. Further research into biomarker combinations could lead to an improved EOS diagnosis, reduce antibiotic overtreatment, and prevent associated health-related problems.
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Affiliation(s)
- Lisanne M van Leeuwen
- Department of Paediatrics and of Vaccine, Infection and Immunology, Spaarne Gasthuis Hospital, Haarlem, the Netherlands; Willem-Alexander Children's Hospital, Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Elandri Fourie
- Department of Paediatrics and of Vaccine, Infection and Immunology, Spaarne Gasthuis Hospital, Haarlem, the Netherlands
| | - Gerrie van den Brink
- Department of Paediatrics and of Vaccine, Infection and Immunology, Spaarne Gasthuis Hospital, Haarlem, the Netherlands
| | - Vincent Bekker
- Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, the Netherlands
| | - Marlies A van Houten
- Department of Paediatrics and of Vaccine, Infection and Immunology, Spaarne Gasthuis Hospital, Haarlem, the Netherlands.
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D'Adamo E, Botondi V, Falconio L, Giardinelli G, Di Gregorio P, Caputi S, Sinjari B, Trubiani O, Traini T, Gazzolo F, Strozzi MC, Maconi A, Gazzolo D. Effect of temperature on presepsin pre-analytical stability in biological fluids of preterm and term newborns. Clin Chem Lab Med 2024; 62:1011-1016. [PMID: 38018456 DOI: 10.1515/cclm-2023-1282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVES Thermostability is one of the pre-requisites for the reliability of analytes in clinical practice and biomedical research. Although presepsin represents a promising new biomarker for the early diagnosis of sepsis in newborns, data on its stability under different storage conditions are lacking. We aimed to investigate presepsin thermostability in blood, urine and saliva samples after thawing at 4 predetermined monitoring time-points in a cohort of preterm and term infants. METHODS We conducted an observational study, where each case served as its own control, in 24 preterm and term infants. Blood, urine and saliva samples were stored at -80 °C for 18 months, and presepsin measured in different biological fluids at thawing (T0), 24 (T1), 48 (T2) and at 72 (T3) hours after thawing. RESULTS No significant differences (p>0.05, for all) in presepsin levels were observed at T0-T3 in the different biological fluids. Furthermore, no differences at T0-T3 were observed in presepsin levels between blood and saliva fluids, whilst urine levels were significantly higher (p<0.05, for all) than blood and saliva at T0-T3. CONCLUSIONS Results on presepsin pre-analytical thermo-stability in different biological fluids after long-term refrigeration support the reliability of this biomarker in the diagnosis and monitoring of perinatal sepsis.
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Affiliation(s)
- Ebe D'Adamo
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | - Valentina Botondi
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
| | - Luigi Falconio
- Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | | | - Patrizia Di Gregorio
- Immunohematology and Transfusional Medicine Service, "SS. Annunziata" Hospital, Chieti, Italy
| | - Sergio Caputi
- Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Bruna Sinjari
- Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Oriana Trubiani
- Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Tonino Traini
- Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Francesca Gazzolo
- Pediatric Unit, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Maria Chiara Strozzi
- Department of Maternal Fetal and Neonatal Medicine, C. Arrigo Children's Hospital Alessandria, Alessandria, Italy
| | - Antonio Maconi
- Department of Maternal Fetal and Neonatal Medicine, C. Arrigo Children's Hospital Alessandria, Alessandria, Italy
| | - Diego Gazzolo
- Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy
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Fellman V. Biomarkers needed to discriminate early onset sepsis from asphyxia in newborn infants. Acta Paediatr 2024; 113:382-383. [PMID: 38196318 DOI: 10.1111/apa.17094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 01/11/2024]
Affiliation(s)
- Vineta Fellman
- Department of Clinical Sciences, Pediatrics, Lund University, Lund, Sweden
- Children's Hospital, University of Helsinki, Helsinki, Finland
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Maddaloni C, De Rose DU, Perulli M, Martini L, Bersani I, Campi F, Savarese I, Dotta A, Ronchetti MP, Auriti C. Perinatal asphyxia does not influence presepsin levels in neonates: A prospective study. Acta Paediatr 2024; 113:453-460. [PMID: 37947046 DOI: 10.1111/apa.17031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
AIM To compare Presepsin (presepsin) levels in plasma and urine of uninfected newborn infants with perinatal asphyxia with those of controls. METHODS In this prospective study, we enrolled 25 uninfected full-term infants with perinatal asphyxia and 19 controls. We measured presepsin levels in whole blood or urine. In neonates with perinatal asphyxia, we compared presepsin levels in blood and urine at four time points. RESULTS In neonates with perinatal asphyxia, blood and urinary presepsin levels matched each other at any time point. At admission, the median presepsin value in blood was similar in both groups (p = 0.74), while urinary levels were higher in hypoxic neonates (p = 0.05). Perinatal asphyxia seemed to increase serum CRP and procalcitonin levels beyond normal cut-off but not those of presepsin. CONCLUSION In uninfected neonates with perinatal asphyxia, median blood and urinary presepsin levels matched each other at any point in the first 72 h of life and seemed to be slightly affected by the transient renal impairment associated with perinatal hypoxia in the first 12 h of life. Perinatal asphyxia did not influence presepsin levels within the first 72 h of life, while those of CRP and procalcitonin increased.
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Affiliation(s)
- Chiara Maddaloni
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Domenico Umberto De Rose
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
- PhD Course in Microbiology, Immunology, Infectious Diseases and Transplants (MIMIT), Faculty of Medicine and Surgery, "Tor Vergata" University of Rome, Rome, Italy
| | - Marco Perulli
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ludovica Martini
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Iliana Bersani
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Francesca Campi
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Immacolata Savarese
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Andrea Dotta
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | | | - Cinzia Auriti
- Casa di Cura Villa Margherita, Rome, Italy
- Saint Camillus International University of Health Sciences, Rome, Italy
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Joshi M, Muneer J, Mbuagbaw L, Goswami I. Analgesia and sedation strategies in neonates undergoing whole-body therapeutic hypothermia: A scoping review. PLoS One 2023; 18:e0291170. [PMID: 38060481 PMCID: PMC10703341 DOI: 10.1371/journal.pone.0291170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/03/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Therapeutic hypothermia (TH) is a widely practiced neuroprotective strategy for neonates with hypoxic-ischemic encephalopathy. Induced hypothermia is associated with shivering, cold pain, agitation, and distress. OBJECTIVE This scoping review determines the breadth of research undertaken for pain and stress management in neonates undergoing hypothermia therapy, the pharmacokinetics of analgesic and sedative medications during hypothermia and the effect of such medication on short- and long-term neurological outcomes. METHODS We searched the following online databases namely, (i) MEDLINE, (ii) Web of Science, (iii) Cochrane Library, (iv) Scopus, (v) CINAHL, and (vi) EMBASE to identify published original articles between January 2005 and December 2022. We included only English full-text articles on neonates treated with TH and reported the sedation/analgesia strategy used. We excluded articles that reported TH on transport or extracorporeal membrane oxygenation, did not report the intervention strategies for sedation/analgesia, and reported hypoxic-ischemic encephalopathy in which hypothermia was not applied. RESULTS The eligible publications (n = 97) included cohort studies (n = 72), non-randomized experimental studies (n = 2), pharmacokinetic studies (n = 4), dose escalation feasibility trial (n = 1), cross-sectional surveys (n = 5), and randomized control trials (n = 13). Neonatal Pain, Agitation, and Sedation Scale (NPASS) is the most frequently used pain assessment tool in this cohort. The most frequently used pharmacological agents are opioids (Morphine, Fentanyl), benzodiazepine (Midazolam) and Alpha2 agonists (Dexmedetomidine). The proportion of neonates receiving routine sedation-analgesia during TH is center-specific and varies from 40-100% worldwide. TH alters most drugs' metabolic rate and clearance, except for Midazolam. Dexmedetomidine has additional benefits of thermal tolerance, neuroprotection, faster recovery, and less likelihood of seizures. There is a wide inter-individual variability in serum drug levels due to the impact of temperature, end-organ dysfunction, postnatal age, and body weight on drug metabolism. CONCLUSIONS No multidimensional pain scale has been tested for reliability and construct validity in hypothermic encephalopathic neonates. There is an increasing trend towards using routine sedation/analgesia during TH worldwide. Wide variability in the type of medication used, administration (bolus versus infusion), and dose ranges used emphasizes the urgent need for standardized practice recommendations and guidelines. There is insufficient data on the long-term neurological outcomes of exposure to these medications, adjusted for underlying brain injury and severity of encephalopathy. Future studies will need to develop framework tools to enable precise control of sedation/analgesia drug exposure customized to individual patient needs.
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Affiliation(s)
- Mahima Joshi
- Faculty of Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Javed Muneer
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence Mbuagbaw
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ipsita Goswami
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Botondi V, D'Adamo E, Plebani M, Trubiani O, Perrotta M, Di Ricco L, Spagnuolo C, De Sanctis S, Barbante E, Strozzi MC, Maconi A, Gazzolo F, Betti M, Roveta A, Levantini G, Gazzolo D. Perinatal presepsin assessment: a new sepsis diagnostic tool? Clin Chem Lab Med 2022; 60:1136-1144. [PMID: 35562321 DOI: 10.1515/cclm-2022-0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/03/2022] [Indexed: 11/15/2022]
Abstract
Perinatal sepsis constitutes a medical emergency and is still one of the major causes of mortality and morbidity. The possibility of an early diagnosis of sepsis is still debated and controversial. In particular, clinical symptoms can be hidden by the association of sepsis with other perinatal diseases and/or by therapeutic strategies performed. In this context, there is evidence that the accuracy of standard of care diagnostic parameters (i.e. blood culture, C-reactive protein, procalcitonin) can be biased by additional confounding factors (gestational age, birth-weight, acute-chronic hypoxia). Therefore, the inclusion in clinical daily practice of new biomarkers of sepsis is of utmost importance. Of a panel of biomarkers, Presepsin (P-SEP) plays an important role in the development and response of the immune system and as an early marker of sepsis both in adult and pediatric patients. Therefore, in the present review we aim to offer an overview of the role of P-SEP in the early detection of perinatal sepsis as a trustworthy marker according to actual statements of official international institutions. Future perspectives regard the possibility of a longitudinal non-invasive biological fluids P-SEP assessment thus limiting the sample stress in high risk newborns.
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Affiliation(s)
- Valentina Botondi
- Neonatal Intensive Care Unit, G. D'Annunzio University, Chieti, Italy
| | - Ebe D'Adamo
- Neonatal Intensive Care Unit, G. D'Annunzio University, Chieti, Italy
| | - Mario Plebani
- Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy
| | - Oriana Trubiani
- Department of Innovative Technologies in Medicine & Dentistry, University "G. D'Annunzio", Chieti, Italy
| | - Marika Perrotta
- Neonatal Intensive Care Unit, G. D'Annunzio University, Chieti, Italy
| | - Laura Di Ricco
- Neonatal Intensive Care Unit, G. D'Annunzio University, Chieti, Italy
| | - Cynzia Spagnuolo
- Neonatal Intensive Care Unit, G. D'Annunzio University, Chieti, Italy
| | - Sara De Sanctis
- Neonatal Intensive Care Unit, G. D'Annunzio University, Chieti, Italy
| | | | | | - Antonio Maconi
- AO SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | | | - Marta Betti
- AO SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | - Annalisa Roveta
- AO SS Antonio, Biagio and C. Arrigo Hospital, Alessandria, Italy
| | | | - Diego Gazzolo
- Neonatal Intensive Care Unit, G. D'Annunzio University, Chieti, Italy
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