The role of presepsin in the evaluation of sepsis in pediatric intensive care unit / Maha Mostafa Alkholy ; Supervised Hala Mohamed Amin Fouad , Hebat Allah Fadel Elgebally , Sally Kamal Ibrahiem

Thesis (Ph.D.) - Cairo University -Faculty of Medicine - Department of Pediatrics

Background: Sepsis is a major challenge in emergency departments and intensive care units (ICUs), causing high mortality and morbidity. Early diagnosis and timely intervention are essential to improve the prognosis of septic patients. Bacterial culture is generally regarded as the gold standard for the diagnosis of sepsis, but it is time-consuming, frequently yields false-negative results, and microbial contamination can greatly affect its diagnostic value. Thus, the treatment of sepsis is often based on the clinician{u2019}s experience, which risks an increase in antibiotic resistance and the cost of medical care. It is therefore necessary and urgent to develop a rapid and accurate method for the diagnosis of sepsis. Presepsin, is a novel and promising biomarker that has been shown to increase significantly in patients with sepsis, in comparison to the healthy population. Aims: To estimate the diagnostic accuracy of presepsin in predicting Sepsis in Pediatric Intensive Care Unit (PICU).Methods: A cases - control study including patients admitted to PICU of Cairo university hospital during the period from April (2016) to May (2017). It included 58 children aged between 1month and 12 years. 32 were septic pediatric patients who were admitted at the PICU and 26 were healthy children. They were age and sex matched.All the patients at this study were subjected to detailed history, clinical examination to assess the initial site of infection and the organism, the hemodynamic parameters, the vasoactive drugs that were taken and the SOFA score. Routine laboratory tests and blood culture were performed. Blood samples were obtained at the first day of the study enrollment and the third day to assess the presepsin level

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