Presepsin as a predictor of septic shock in patients with urinary tract infection

被引：11

作者：

Sekine, Yoshitaka ^{[1
]}

Kotani, Kazuhiko ^{[2
]}

Oka, Daisuke ^{[1
]}

Nakayama, Hiroshi ^{[1
]}

Miyazawa, Yoshiyuki ^{[1
]}

Syuto, Takahiro ^{[1
]}

Arai, Seiji ^{[1
]}

Nomura, Masashi ^{[1
]}

Koike, Hidekazu ^{[1
]}

Matsui, Hiroshi ^{[1
]}

Shibata, Yasuhiro ^{[1
]}

Murakami, Masami ^{[3
]}

Suzuki, Kazuhiro ^{[1
]}

机构：

[1] Gunma Univ, Dept Urol, Grad Sch Med, 3-39-22 Showa Machi, Maebashi, Gumma 3718511, Japan

[2] Jichi Med Univ, Div Community & Family Med, Dept Clin Lab Med, Shimotsuke, Tochigi, Japan

[3] Gunma Univ, Dept Clin Lab Med, Grad Sch Med, Maebashi, Gumma, Japan

来源：

BMC UROLOGY | 2021年 / 21卷 / 01期

关键词：

Bacterial infections; Biomarkers; C-reactive protein; Cytokines; Endotoxins; Flank pain; Presepsin; Urinary tract infection; Sepsis; procalcitonin; SEPSIS; PROCALCITONIN; DEFINITIONS;

D O I：

10.1186/s12894-021-00906-4

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background Recently, presepsin has been reported to be a useful biomarker for early diagnosis of sepsis and evaluation of prognosis in septic patients. However, few reports have evaluated its usefulness in patients with urinary tract infections (UTI). This study aimed to evaluate whether presepsin could be a valuable marker for detecting severe sepsis, and whether it could predict the therapeutic course in patients with UTI compared with markers already used: procalcitonin (PCT) and C-reactive protein (CRP). Methods From April 2014 to December 2016, a total of 50 patients with urinary tract infections admitted to Gunma university hospital were enrolled in this study. Vital signs, presepsin, PCT, CRP, white blood cell (WBC) count, causative agents of urinary-tract infections, and other data were evaluated on the enrollment, third, and fifth days. The patients were divided into two groups: with (n = 11) or without (n = 39) septic shock on the enrollment day, and with (n = 7) or without (n = 43) sepsis on the fifth day, respectively. Presepsin was evaluated as a biomarker for systemic inflammatory response syndrome (SIRS) or septic shock. Results Regarding the enrollment day, there was no significant difference of presepsin between the SIRS and non-SIRS groups (p = 0.276). The median value of presepsin (pg/mL) was significantly higher in the septic shock group (p < 0.001). Multivariate logistic regression analysis showed that presepsin (>= 500 pg/ml) was an independent risk factor for septic shock (p = 0.007). ROC curve for diagnosing septic shock indicated an area under the curve (AUC) of 0.881 for presepsin (vs. 0.690, 0.583, and 0.527 for PCT, CRP and WBC, respectively). Regarding the 5th day after admission, the median presepsin value on the enrollment day was significantly higher in the SIRS groups than in the non-SIRS groups (p = 0.006). On the other hand, PCT (>= 2 ng/ml) on the enrollment day was an independent risk factor for SIRS. ROC curve for diagnosing sepsis on the fifth day indicated an AUC of 0.837 for PCT (vs. 0.817, 0.811, and 0.802 for presepsin, CRP, and WBC, respectively). Conclusions This study showed that presepsin may be a good marker for diagnosing septic shock based on admission data in patients with UTI.

引用

页数：7

共 21 条

[1] Influence of renal dysfunction on the accuracy of procalcitonin for the diagnosis of postoperative infection after vascular surgery [J].