The Utility of Soluble CD14 Subtype in Early Diagnosis of Culture-Proven Early-Onset Neonatal Sepsis and Prediction of Outcome.

Objective: This study aimed to evaluate soluble cluster of differentiation 14 subtype (sCD14-ST), also named presepsin, as an early marker for the diagnosis of culture-proven early-onset sepsis (EOS) in neonates and to assess its relation to disease severity and mortality.

Study Design: Out of 60 neonates with risk factors of EOS, 31 neonates were diagnosed as having culture-proven EOS. They were compared with 20 nonseptic controls. We obtained blood samples on day 1 of life for sCD14-ST measurement and sepsis screening. Blood samples were repeated on day 3 in EOS neonates.

Results: sCD14-ST was significantly higher in EOS neonates than controls ( < 0.001). Neonates who later developed septic shock had significantly higher day 1 sCD14-ST level than those who did not ( < 0.001). Furthermore, neonates who died had significantly higher day 1 sCD14-ST than survivors ( < 0.001). On day 3, there was a significant decline in sCD14-ST levels than initial levels among survivors. There was a significant positive correlation between day 1 sCD14-ST level and Tollner's sepsis severity score.

Conclusion: sCD14-ST could be used as a powerful diagnostic and prognostic marker of EOS. Its quantitative measurement at birth could be a good predictor of sepsis severity and mortality.