Plasmatic presepsin (sCD14-ST) concentrations in acute pyelonephritis in adult patients

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• 作者：Yann-Erick Claessens^a ; ^b ; Eloise Trabattoni^b ; ^k ; Sophie Grabar^c ; ^l ; Laurent Quinquis^c ; ^l ; Guillaume Der Sahakian^b ; Marine Anselmo^d ; Jeannot Schmidt^e ; Jean-Emmanuel de la Coussaye^f ; Patrick Plaisance^g ; Enrique Casalino^h ; ^m ; Gilles Potelⁱ ; Franç ; ois Lecomte^b ; Didier Borderie^d ; ^j ; Camille Chenevier-Gobeaux^d ; ^{camille.gobeaux@aphp.fr}
• 关键词：Urinary tract infection ; Biomarkers ; Presepsin ; Procalcitonin ; C-reactive protein ; Emergency medicine
• 刊名：Clinica Chimica Acta
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：464
• 期：Complete
• 页码：182-188
• 全文大小：688 K
• 卷排序：464

文摘

Presepsin (sCD14-ST) is an emerging biomarker for infection. We hypothesized that presepsin could specifically increase during acute pyelonephritis and correlate with severity.MethodsWe compared presepsin values in patients with acute pyelonephritis and controls, and we assessed its capacity to predict bacteraemia and admission in patients.ResultsIn 312 patients with acute pyelonephritis (median age 33 years), presepsin concentrations were higher than in controls (476 vs 200 ng/L, p < 0.001). ROC curve indicated an AUC at 0.90 [for presepsin (vs. 0.99 and 0.98 for CRP and PCT, respectively; p < 0.05) and an optimal threshold at 340 ng/L (74% sensitivity, 94% specificity). Presepsin concentrations increased in acute pyelonephritis patients with bacteraemia (614 vs. 461 ng/L, p,=0.001) and in those requiring admission (614 ng/L vs. 320 ng/L, p < 0.001). Performance of presepsin to predict bacteraemia [AUC = 0.63, 95%CI: 0.55–0.72] was similar to CRP (AUC = 0.64, p = 0.87) and less accurate than PCT (AUC = 0.78, p < 0.001). AUC for presepsin to detect the need for admission was 0.67, and comparable to CRP (p = 0.26) and PCT (p = 0.18).ConclusionPresepsin is a valuable biomarker to detect patients with acute pyelonephritis. However, it presents mild performance to predict bacteraemia and the need for admission, and offers no advantage as compared to CRP and PCT.