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Presepsin, resistin may aid in bacterial infection diagnosis in patients with cirrhosis

12 Dec 2019

Presepsin and resistin appear to be helpful early markers of bacterial infection in patients with decompensate cirrhosis, a recent study has shown.

Researchers enrolled 114 consecutive patients (mean age, 60±10 years; 74.5 percent male) with decompensated liver cirrhosis from whom venous blood samples were drawn. Concentrations of the biomarkers were determined using the appropriate test kits. Bacterial infections were determined through culture positivity and cell counts.

Almost half of the patients were positive for bacterial infections upon admission; 14 were infected at multiple sites and 30 satisfied the criteria for sepsis. Spontaneous bacterial peritonitis was the most frequent infection. Presepsin and resistin, along with C-reactive protein (CRP) and procalcitonin, were all enriched in those who had infections and sepsis.

Presepsin was significantly diagnostic of infections (area under the receiver operating characteristic curve [AUROC], 0.75, 95 percent confidence interval [CI], 0.67–0.84; p<0.001). Its performance was not significantly different than for CRP (p=0.87), procalcitonin (p=0.54) and resistin (p=0.76).

At an identified optimal cutoff value of 1,444 pg/mL, prespsin was able to accurately identify infection in 70 percent of patients and sepsis in 80 percent. However, when using the prespecified cutoff of 600 pg/mL, used in noncirrhotic patients, accuracy dropped to 60 percent (p=0.2) and 53 percent (p<0.0001), respectively.

Resistin performed comparably. At the cutoff of 20 ng/mL, 71 percent and 70 percent of patients could correctly be identified as having an infection or sepsis, respectively. Raising the threshold to 36.5 ng/mL worsened accuracy to 67 percent for infections but improved to 73 percent for sepsis.

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Most Read Articles
Elvira Manzano, 2 days ago
Monthly injections of the PCSK9* monoclonal antibody evolocumab effectively reduced plasma LDL-cholesterol (LDL-C), often referred to as the bad cholesterol, in teenagers with heterozygous familial hypercholesterolaemia (HeFH) already taking statins, with or without ezetimibe, the HAUSER-RCT has shown.
Jairia Dela Cruz, 2 days ago
For individual with type 2 diabetes, losing weight is everything when it comes to improving the metabolic function, and it matters little whether this is achieved by dieting or undergoing bariatric surgery, according to a small study.
Pearl Toh, 21 Sep 2020
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
2 days ago
In patients with type 2 diabetes (T2D), postprandial hyperglycaemia and hypertriglyceridemia worsens survival outlook, finds a new study.