Gatto Antonio, Mantani Lucia, Gola Caterina, Pansini Valeria, Di Sarno Lorenzo, Capossela Lavinia, Ferretti Serena, Graglia Benedetta, Chiaretti Antonio
Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy.
Department of Pediatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Children (Basel). 2024 May 15;11(5):594. doi: 10.3390/children11050594.
Sepsis is a life-threatening condition that affects 1.2 million children annually. Although there are several criteria for diagnosing this condition, signs are often nonspecific, and identifying sepsis is challenging. In this context, presepsin (P-SEP) seems to be a promising new biomarker since its plasma levels increase earlier than other sepsis-related proteins and its measurement is faster. We enrolled 157 minors who presented to the Pediatric Emergency Department of Agostino Gemelli Hospital with fever and suspected sepsis. Biochemical, anamnestic, and clinical data were collected. Viral agents were identified as the causative factor in 64 patients, who had an average P-SEP value of 309.04 pg/mL (SD ± 273.2), versus an average P-SEP value of 526.09 pg/mL (SD ± 657) found in 27 bacterial cases ( value: 0.0398). Four cases of overt sepsis had an average P-SEP value of 3328.5 pg/mL (SD ± 1586.6). The difference in P-SEP levels in viral versus bacterial infections was found to be statistically significant; therefore, P-SEP may have a central role in the evaluation of febrile children, helping clinicians distinguish between these two etiologies. Furthermore, amongst the cases of confirmed sepsis, P-SEP was always greater than 2000 pg/mL, while C-reactive protein and procalcitonin values appeared lower than what was considered significant.
脓毒症是一种危及生命的病症，每年影响120万儿童。尽管有多种诊断该病症的标准，但症状往往不具特异性，识别脓毒症具有挑战性。在这种情况下，前降钙素（P-SEP）似乎是一种很有前景的新生物标志物，因为其血浆水平比其他脓毒症相关蛋白升高得更早，而且检测速度更快。我们招募了157名到阿戈斯蒂诺·杰梅利医院儿科急诊科就诊、伴有发热且疑似脓毒症的未成年人。收集了生化、既往史和临床数据。在64例患者中确定病毒病原体为致病因素，这些患者的P-SEP平均 值为309.04 pg/mL（标准差±273.2），而在27例细菌感染病例中发现的P-SEP平均值为526.09 pg/mL（标准差±657）（ 值：0.0398）。4例显性脓毒症患者的P-SEP平均值为3328.5 pg/mL（标准差±1586.6）。发现病毒感染与细菌感染的P-SEP水平差异具有统计学意义；因此，P-SEP可能在发热儿童的评估中起核心作用，有助于临床医生区分这两种病因。此外，在确诊的脓毒症病例中，P-SEP始终大于2000 pg/mL，而C反应蛋白和降钙素原的值似乎低于被认为有意义的值。
