Current biomarkers in sepsis

Objective: Sepsis is a major cause of deaths in intensive care units. It is claimed that sepsis affects more than 30 million people annually and causes 5 million deaths. In 2011, it was found that sepsis and related complications accounted for over $20 billion in expenditures in the United States. For these reasons, sepsis can be considered a public health issue. It has been determined that initiating appropriate antibiotic therapy within the first hour of sepsis treatment reduces mortality. This study aims to determine the diagnostic performance of four parameters that we believe may have early diagnostic value in sepsis and to compare them with CRP and procalcitonin. Methods: The four parameters whose diagnostic performance will be calculated are sTREM1, presepsin, neutrophil CD64, and calprotectin. Sepsis patients were selected from those treated in the Intensive Care Unit of Pamukkale University between January 1, 2023, and January 31, 2024. After applying exclusion criteria, 76 sepsis patients were included in the study. A control group consisting of 76 healthy volunteers was included in the study. Calprotectin, presepsin, and sTREM1 parameters were measured using a commercial ELISA kit. The neutrophil CD64 parameter was measured by flow cytometry. CRP was measured immunoturbidimetrically on the Roche c702 module, and procalcitonin was measured using electrochemiluminescence on the Roche e801 module. Results: No significant differences were found in the demographic characteristics between the patient and control groups. Six parameters, including CRP and PCT, were found to be significantly higher in the patient group compared to the control group (p<0.05). The diagnostic performance of the parameters, as determined by ROC curve analyses, is presented in the table below. Table 11: Summary of All Parameter's Diagnostic Performance Parameter AUC ( %95 CI) Cut-Off Duyarlılık Özgüllük S-TREM 1 0,806 (0,735-0,877) 54,8 (pg/mL) 0,645 0,947 Calprotectin 0,625 (0,533-0,717) 1041 (ng/mL) 0,368 1 Neutrophil CD 64 0,924 (0,890-0,968 895 (MFI) 0,934 0,803 Presepsin 0,834 (0,773-0,895) 99,1 (pg/mL) 0,855 0,645 CRP 0,922 (0,876-0,969) 51,7 (mg/L) 0,816 1 PCT 0,853 (0,790-0,916) 1,1 (ng/mL) 0,632 1 Conclusion: When the diagnostic performance data were evaluated, the highest performance was found in the Neutrophil CD 64 parameter. CRP shows values very close to the nCD64 parameter. Presepsin and procalcitonin also showed comparable performance with CRP and NCD64. The diagnostic performance of calprotectin was found to be low compared to other parameters. Key Words: Sepsis, Biomarker, Presepsin, Kalprotektin, nCD64, sTREM1