Introduction: Sepsis represents a major cause of morbidity and mortality in critically ill patients. Early diagnosis and appropriate treatment have a crucial influence on survival. The aim of this study was to evaluate the diagnostic and prognostic role of presepsin (sCD14) in patients with sepsis. Methodology: Fifty-four consecutive adult patients with sepsis and 26 patients with aseptic meningitis as a control group were included in this prospective observational study. In all patients included in the study, levels of C-reactive protein (CRP), presepsin, lactate, and a count of leukocytes and neutrophils were determined on admission. In those with suspected bacterial infection, two separate blood cultures were obtained and procalcitonin (PCT) concentration was detected. Plasma presepsin and PCT concentrations in septic group patients were followed on days 2, 3 and 7 after enrollment. Results: The median presepsin serum concentration in patients with sepsis was 1614 pg/mL and in the control group it was 203 pg/mL (p < 0.001). Presepsin levels in patients with septic shock were higher than in sepsis patients (p < 0.014). The mean presepsin concentrations were higher in deceased than in surviving patients (p = 0.009). The trend of changes in presepsin concentrations in deceased patients was significantly different than in the surviving patients (p = 0.018). There were no statistically significant differences in the concentration of presepsin or other biomarkers in patients with Gram negative or Gram positive bacteria. Conclusions: Presepsin may be used as a diagnostic marker of systemic bacterial infection and can predict the severity and outcome of sepsis.

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Mycoplasma pneumoniae (Mp) is a common cause of lower respiratory tract infection (LRTI) in children that is difficult to distinguish from LRTI of other etiologies. We aimed to determine if a combination of clinical, laboratory, and chest radiographic features can help identify patients at higher risk of Mp LRTI. We reviewed medical charts of children referred to our tertiary hospital with suspected acute mycoplasmal LRTI. Pharyngeal swabs obtained from patients were tested by Mp PCR. We compared epidemiological and clinical data of children with positive and negative Mp PCR results. In addition, a multivariable logistic regression analysis was performed to predict Mp LRTI based on the patient’s age, duration of symptoms, presence of extrapulmonary manifestations, laboratory findings, and chest radiographic findings. We included 65 children with Mp PCR-negative and 49 with Mp PCR-positive LRTI and no viral co-detection. Children with Mp LRTI were older (median age 5.8 vs. 2.2 years, p < 0.001), had a longer duration of symptoms on referral (median 7 vs. 4 days, p < 0.001), and lower median WBC (9.9 vs. 12.7 × 109/L, p < 0.001). On chest radiograph, unilateral infiltrates were more frequently observed in the Mp PCR-positive group (57.5% vs. 24.1%, p = 0.001). Age, duration of symptoms, and chest radiographic findings had the highest predictive value for Mp LRTI in a multivariable logistic regression model. Our analysis suggests that a combination of clinical, laboratory, and chest radiographic features can be used to assess the likelihood of Mp LRTI and assist in decision-making for which children need further tests or macrolide antibiotic treatment.

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