Presepsin is a potent biomarker for diagnosing skin wound infection in hemodialysis patients compared to white blood cell count, high-sensitivity C-reactive protein, procalcitonin, and soluble CD14

被引：0
作者：
Shiota J. [1 ,2 ]
Tagawa H. [2 ]
Ohura N. [3 ]
Kasahara H. [2 ]
机构：
[1] Department of Internal Medicine, Tsunashima Kidney Clinic, 1-10-4 Tsunashima-Higashi, Kohoku-ku, Yokohama
[2] Department of Internal Medicine, Kichijoji Asahi Hospital, Tokyo
[3] Department of Plastic, Reconstructive and Aesthetic Surgery, Kyorin University School of Medicine, Tokyo
来源：
Renal Replacement Therapy | / 3卷 / 1期
关键词：
Hemodialysis; hsCRP; Localized infection; Presepsin; Procalcitonin; Skin wound infection; Soluble CD 14;
D O I：
10.1186/s41100-017-0113-z
中图分类号：
学科分类号：
摘要：
Background: The production of presepsin has been shown to be strongly related to bacterial phagocytosis. The purpose of the present study is to compare the usefulness of presepsin for diagnosing localized skin wound infection with that of conventional infection biomarkers. Methods: We enrolled 29 hemodialysis (HD) patients with skin wound infections of foot gangrene or decubitus ("localized infection group") and 20 HD patients without infection ("no infection group"). The white blood cell (WBC) count and high-sensitivity C-reactive protein (hsCRP) and presepsin levels were measured using blood samples collected before HD, 2 days after the previous dialysis session. Soluble CD14 (sCD14) and procalcitonin (PCT) levels were also measured in 12 patients with localized infection and 8 patients without infection. Results: The levels of hsCRP and presepsin were significantly higher in the localized infection group (N = 29) than in the no infection group (N = 20) (P = 0.0209 and 0.0000, respectively). In receiver operating characteristics (ROC) analyses, when the cut-off values of hsCRP and presepsin were set at 1.07 mg/dL and 2080 pg/mL, respectively, the sensitivity was 0.69 and 0.86, and the specificity was 0.70 and 0.80, respectively. The area under the curve (AUC) was calculated as 0.696 for hsCRP and 0.874 for presepsin. The AUC for presepsin was significantly higher than that for hsCRP (P = 0.0348). No marked differences were found in the age, gender, WBC, or sCD14 or PCT levels between groups. Conclusions: Presepsin is a potent, useful biomarker for diagnosing skin wound infection in HD patients compared to conventional infection biomarkers. © 2017 The Author(s).
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共 33 条
[1]  
Fujioka M., Oka K., Kitamura R., Yakabe A., Complex wounds tend to develop more rapidly in patients receiving hemodialysis because of diabetes mellitus, Hemodial Int., 13, pp. 168-171, (2009)
[2]  
Kingsley A., The wound infection continuum and its application to clinical practice, Ostomy Wound Manag, 49, pp. 1-7, (2003)
[3]  
Woo K.Y., Sibbald R.G., A cross-sectional validation study of using NERDS and STONEES to assess bacterial burden, Ostomy Wound Manag., 55, pp. 40-48, (2009)
[4]  
Yaegashi Y., Shirakawa K., Sato N., Et al., Evaluation of a newly identified soluble CD14 subtype as a marker for sepsis, J Infect Chemother., 11, pp. 234-238, (2005)
[5]  
Shozushima T., Takahashi G., Matsumoto N., Kojika M., Okamura Y., Endo S., Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome, J Infect Chemothr., 17, pp. 764-769, (2011)
[6]  
Arai Y., Mizugishi K., Nonomura K., Naitoh K., Takaori-Kondo A., Yamashita K., Phagocytosis by human monocytes is required for the secretion of presepsin, J Infect Chemothr., 21, pp. 564-569, (2015)
[7]  
Naitoh K., Shirakawa K., Hirose J., Nakamura M., Et al., The new sepsis marker, sCD14-ST (PRESEPSIN), induction mechanism in the rabbit sepsis models, Crit Care, 14, SUPPL 2, (2010)
[8]  
Shiota J., Ohura N., Higashikawa S., Et al., Presepsin as a predictor of critical colonization in CLI hemodialysis patients, Wound Rep Reg., 24, pp. 189-194, (2016)
[9]  
Papp M., Tornai T., Vitalis Z., Tornai I., Tornai D., Dinya T., Et al., Presepsin teardown-pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis, World J Gastroenterol., 22, pp. 9172-9185, (2016)
[10]  
Okamura Y., Yokoi H., Development of a point-of-care assay system for measurement of presepsin (sCD14-ST), Clin Chim Acta., 412, pp. 2157-2161, (2011)
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