Irisin and presepsin as novel neonatal sepsis biomarkers

Sepsis is one of the leading causes of morbidity and mortality in newborns, and its diagnosis and treatment is urgent. Definitive diagnosis is made based on the presence of bacterial multiplication in the blood culture. However, the absence of signs and symptoms specific to sepsis, prolonged time to obtain the results of the blood culture, and the probability to obtain false positive results complicates the diagnosis. Several laboratory methods have been developed to make a definitive and early diagnosis. The aim of this study is to compare serum C-reactive protein (CRP), irisin (IRI) and presepsin, and white blood cell count (WBC) in neonatal sepsis. This study was performed in Fırat University, Faculty of Medicine, Department of Pediatrics, Neonatal Intensive Care Unit between September 2015 and November 2016. The study population comprised sepsis (n=30) and control (n=28) groups. All samples were collected before the initiation of antibiotic therapy. The most appropriate cut-off values for the diagnosis of sepsis were 10,6 mg/dL for CRP (sensitivity 96%, specificity 93%) and 1.99 mg/L for presepsin (sensitivity 89%, specificity 63%). Area under the curve for CRP, presepsin, and IRI were 0.977, 0.831 and 0,157, respectively. The CRP and presepsin values of the sepsis group were significantly higher than the control group (p<0.05). Furthermore, IRI levels were significantly higher in the control group than the sepsis group (p<0.05). In conclusion, we found that sensitivity of CRP and presepsin values were higher for the diagnosis of neonatal sepsis. Therefore, we suggest that the decrease in irisin can be used as a diagnostic marker. Key Words: C-reactive protein, neonatal, sepsis, presepsin, irisin.