The place of presepsin in febrile neutropenic patients for follow-up

Objective : It is shown that presepsin has an early diagnostic value in sepsis. In our study, it is aimed to determine the place of presepsin in infection diagnosis and follow-up of febrile neutropenia by comparing it with other biomarkers. Material and Method: Patients with hematological cancer who were followed up between 15.1.2019 and 15.12.2019 were included in the study. Febrile neutropenic patients in the case group were evaluated every 48 hours for two weeks from the onset of fever, and afebrile neutropenic patients in the control group once. Presepsin levels in the serum samples of the patients were measured by CLEIA (chemiluminescent enzyme immunassay) method. Results: CRP, procalcitonin and presepsin measured at the onset of fever in the case group were significantly higher than the control group (p: 0.001, p: 0.002, p: 0.001). Presepsin and procalcitonin were found to be significantly higher at 48th hour at those with infection then those with fever of unknown origin (p: 0.04, p: 0.01) and both presepsin and procalcitonin had a diagnostic value for the distinction of infection. In patients with bacteremia, procalcitonin was found to be significantly higher at 48th hour compared to those with fever of unknown origin (p: 0.01) and it was found to have a diagnostic value in the distinction between bacteremia and fever of unknown origin. In patients with sepsis clinic; presepsin (p: 0,02) and procalcitonin (p: 0,04) at the onset of fever, presepsin (p: 0,01), procalcitonin (p: 0,001) and CRP (p: 0,003) at the 48th hour was significantly higher than those without. For the distinction of sepsis; presepsin at the onset of fever and presepsin, procalcitonin and CRP at 48th hour had a diagnostic value. Conclusion: In sepsis, at the onset of fever presepsin has a diagnostic value, unlike CRP and procalcitonin; at 48th hour the diagnostic value of procalcitonin was higher than presepsin and CRP. It was observed that presepsin and CRP had no diagnostic value in the separation of bacteremia from fever with unknown origin, but procalcitonin had a diagnostic value at 48th hour after fever. Considering the different releasing times and half-lives of biomarkers, it is thought to be more meaningful to monitor them at certain intervals and to evaluate these results together with the clinic.