Inflammatory Markers OF Sepsis IN Pediatrics CASES

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Vol. 13 No. 4 (2025): 2025 Volume -13 - Issue 4

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October 29, 2025
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Inflammatory Markers OF Sepsis IN Pediatrics CASES

https://doi.org/10.61096/ijamscr.v13.iss4.2025.676-682
Mahadevaiah V
MBBS, MD. Department of Pediatrics, Chandramma Dayananda Sagar Institute of Medical Education and Research. Bengaluru, Karnataka, India
Srinath Meera. K
MBBS, MD. Department of Biochemistry, Ramaiah Medical College and Hospital. Bengaluru, Karnataka, India.

Corresponding Author(s) : Srinath Meera. K

meerasrinath@hotmail.com

International Journal of Allied Medical Sciences and Clinical Research, Vol. 13 No. 4 (2025): 2025 Volume -13 - Issue 4

Abstract

Background: Sepsis is currently one of the important problems in medicine due to its complexity from pathophysiologic, clinical and therapeutic perspectives. The study was aimed to assess the levels of inflammatory markers and evaluate their performance in predicting severity and outcome in pediatric sepsis cases. Methods:  The study included 84 cases admitted to pediatric intensive care unit with suspicion of sepsis based on International Pediatric Sepsis Consensus Criteria for sepsis (2005). Blood sample from cases were assessed for serum presepsin, procalcitonin, C-reactive protein in addition to routine investigations in sepsis including blood culture at the time of admission. Results: The study sample comprised 47 cases with sepsis and 37 cases with severe sepsis. The mean values of serum presepsin, procalcitonin and C-reactive protein in severe sepsis were significantly higher in comparison to sepsis cases with p value <0.01. The rise in serum presepsin was six fold in severe sepsis as compared to its rise in sepsis cases. However, increase in C-reactive protein was two folds in severe sepsis cases as compared to sepsis cases.  The area under the curve (AUC) of serum presepsin (0.814) was highest followed by C-reactive protein (0.749) and procalcitonin (0.718) in predicting the severity. With serum presepsin value greater than 650 pg. /ml, had 80% positive predictive value and 76% negative predictive value. Serum presepsin showed higher specificity (95 % against 55% and 49%) and positive predictive value (55 % against 17% and 15%) than procalcitonin and C-reactive protein respectively, in predicting mortality.  Interpretation and Conclusion: Serum presepsin was found to be better inflammatory marker of sepsis than procalcitonin and C-reactive protein in predicting both severity and mortality in these cases.         

Keywords

inflammatory markers presepsin procalcitonin sepsis
1.
V M, Meera. K S. Inflammatory Markers OF Sepsis IN Pediatrics CASES. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2025 Oct. 29 [cited 2026 May 1];13(4):676-82. Available from: https://ijamscr.com/ijamscr/article/view/1689
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References
  1. Delano MJ, Ward PA. The immune system's role in sepsis progression, resolution and long‐term outcome. Immunological reviews. 2016, 274(1), 330-353. doi:10.1111/ imr. 12499.
  2. Lewis DH, Chan DL, Pinheiro D, Armitage‐Chan E, Garden OA. The immunopathology of sepsis: pathogen recognition, systemic inflammation, the compensatory anti‐inflammatory response, and regulatory T cells. Journal of Veterinary Internal Medicine. 2012, 26(3), 457-482. doi: 10.1111/j.1939-1676.2012.00905.x
  3. Hotchkiss RS, Moldawer LL, Opal SM, Reinhart K, Turnbull IR, Vincent JL. Sepsis and septic shock. Nature reviews Disease primers. 2016, 2(1), 1-21.
  4. Patil HV, Patil VC. Comparative study of procalcitonin and C-reactive protein in patients with sepsis. Journal of Natural Science, Biology and Medicine. 2020, 11(2), 93-97. DOI:10.4103/jnsbm.JNSBM_1_20
  5. Wong, H.R. Pediatric sepsis biomarkers for prognostic and predictive enrichment. Pediatr Res. 2022, 91(2), 283–288. https://doi.org/10.1038/s41390-021-01620-5
  6. Lever A, Mackenzie I. Sepsis: definition, epidemiology and diagnosis. BMJ. 2007, 335(7625), 879-883. doi:10.1136/bmj.39346.495880.AE
  7. Tan M, Lu Y, Jiang H, Zhang L. The diagnostic accuracy of procalcitonin and C‐reactive protein for sepsis: A systematic review and meta‐analysis. Journal of cellular biochemistry. 2019, 120(4), 5852-5859.
  8. Formenti P, Gotti M, Palmieri F, Pastori S, Roccaforte V, Menozzi A, Galimberti A, Umbrello M, Sabbatini G, Pezzi A. Presepsin in critical illness: current knowledge and future perspectives. Diagnostics. 2024, 14(12), 1311-1327. doi: 10.3390/ diagnostics 14121311.
  9. Velissaris D, Zareifopoulos N, Karamouzos V, Karanikolas E, Pierrakos C, Koniari I, Karanikolas M. Presepsin as a diagnostic and prognostic biomarker in sepsis. Cureus. 2021, 13(5), 1-14. doi: 10.7759/cureus.15019.
  10. Khera D, Toteja N, Singh S, et al. Is There a Role of Presepsin as a Novel Biomarker in Pediatric Sepsis? Indian J Crit Care Med. 2022, 26(6), 712-716. doi : 10.5005/jp-journals-10071-24202
  11. Schlapbach LJ, Watson RS, Sorce LR, Argent AC, Menon K, Hall MW, Akech S, Albers DJ, Alpern ER, Balamuth F, Bembea M. International consensus criteria for pediatric sepsis and septic shock. JAMA. 2024, 331(8), 665-674. doi: 10.1001/ jama. 2024.0179.
  12. Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Frontiers in immunology. 2018, 9, 754, 1-11. doi: 10.3389/fimmu.2018.00754.
  13. Zhao D, Zhou J, Haraguchi G, Arai H, Mitaka C.(2014). Procalcitonin for the differential diagnosis of infectious and non-infectious systemic inflammatory response syndrome after cardiac surgery. Journal of Intensive care. 2014, 2(1), 35. doi : 10.1186/2052-0492-2-35.
  14. Takegawa R, Kabata D, Shimizu K, Hisano S, Ogura H, Shintani A, Shimazu T. Serum albumin as a risk factor for death in patients with prolonged sepsis: an observational study. Journal of critical care. 2019, 51,139-144.https://doi.org/ 10.1016/ j.jcrc. 2019. 02.004.
  15. Ozkan S, Kahveci U, Hur I, Halici A. Prognostic importance of serum presepsin level in pneumonia focal sepsis and its relationship with other biomarkers and clinical severity scores. Saudi medical journal. 2021, 42(9), 994. doi: 10.15537 /smj.2021. 42. 9. 20210163.
  16. Ghazy, Mai M.a; El-Halaby, Hanan A.a,; El-Sabbagh, Amr M.b; Shaltout, Ali A.a. Diagnostic and prognostic values of soluble CD14 (presepsin) in sepsis in pediatric intensive-care patients. Alexandria Journal of Pediatrics. 2018, 31(3), 141-147. DOI: 10.4103/AJOP.AJOP_32_18.
  17. Galliera E, Massaccesi L, de Vecchi E, Banfi G, Romanelli MM. Clinical application of presepsin as diagnostic biomarker of infection: overview and updates. Clinical Chemistry and Laboratory Medicine (CCLM). 2019, 58(1), 11-17. https://doi.org/ 10.1515/cclm-2019-0643.
  18. Lee S, Song J, Park DW, Seok H, Ahn S, Kim J, Park J, Cho HJ, Moon S.. Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: a prospective observational study according to the Sepsis-3 definitions. BMC infectious diseases. 2022, 22(1), 8. https://doi.org/10.1186/s12879-021-07012-8.
  19. He RR, Yue GL, Dong ML, Wang JQ, Cheng C. Sepsis biomarkers: advancements and clinical applications—a narrative review. International journal of molecular sciences. 2024, 25(16), 9010. https://doi.org/10.3390/ijms25169010.
  20. Masson S, Caironi P, Spanuth E, Thomae R, Panigada M, Sangiorgi G, Fumagalli R, Mauri T, Isgrò S, Fanizza C, Romero M. Presepsin (soluble CD14 subtype) and procalcitonin levels for mortality prediction in sepsis: data from the Albumin Italian Outcome Sepsis trial. Critical care. 2014, 18(1), R6. http://ccforum.com/content/18/1/R6.
  21. Yoon SH, Kim EH, Kim HY, Ahn JG. Presepsin as a diagnostic marker of sepsis in children and adolescents: a systemic review and meta-analysis. BMC Infectious Diseases. 2019, 19(1), 760-771.. https://doi.org/10.1186/s12879-019-4397-1
  22. Behnes M, Bertsch T, Lepiorz D, Lang S, Trinkmann F, Brueckmann M, Borggrefe M, Hoffmann U. Diagnostic and prognostic utility of soluble CD 14 subtype (presepsin) for severe sepsis and septic shock during the first week of intensive care treatment. Critical Care. 2014, 18(5),507. http://ccforum.com/content/18/5/507.
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