Clinical use of presepsin

Why choose PATHFASTTM Presepsin?

Presepsin is a reliable, specific and sensitive biomarker for sepsis and a valuable tool for the very early diagnosis of sepsis by Gram-negative and Gram-positive bacteria or fungi [1]. Presepsin rises earlier than other biomarker and does not show unspecific increases [2]. Presepsin values help to stratify the severity of the septic disease with excellent correlation to APACHE II-, GCS-, MEDS- and SOFA-score [3]. Presepsin exceeds the prognostic power of other sepsis biomarkers and is specifically useful when combined with clinical risk scores like e.g. qSOFA [4].
The time course of Presepsin can be used for monitoring: a decline demonstrates response to therapy and predicts a favorable outcome [5,6]. Presepsin is an accurate biomarker in the diagnosis of neonatal sepsis with higher cut off values [7,8].
In cardiac surgery elevated preoperative plasma Presepsin concentration is a strong predictor of postoperative mortality in cardiac surgery patients [9].

Early marker of sepsis (Fig. 2)
The Presepsin molecule is characterized by rapid kinetics: activation time is only 2 hours following a bacterial or fungal event, with a peak concentration after 3 hours. This characteristic makes the Presepsin molecule the fastest biomarker for sepsis in relation to procalcitonin (PCT) and C-Reactive Protein (CRP), which have activation times of 6-12 hours and 12-24 hours, respectively. The half life of the molecule in plasma is 4-5 hours, compared to 12-24 hours for PCT, allowing more effective and earlier management of the pharmacological treatment.
Presepsin (in orange) and other markers in post-traumatic patients following a serious burn were considered. It is well-known that Presepsin does not change after the trauma but there is an early increase in the values of Presepsin by day 2 following the occurrence of a bacterial infection confirmed by a positive blood culture of day 5. Effectiveness of antibiotic treatment is shown at day 13.
Moreover, when patients were divided into an infection group and a non-infection group and ROC curves of each of the markers were plotted to compare Presepsin with other markers, the results showed that Presepsin was the best, followed by CRP, IL-6, and PCT [2].