Presepsin in Neonatal Sepsis: A Single-Center Evaluation in Comparison to Conventional Markers

Objective: Neonatal sepsis is a leading cause of morbidity and mortality in newborns. Timely and accurate diagnosis remains a challenge due to the nonspecific clinical signs and the limited sensitivity and specificity of conventional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and white blood cell (WBC) count. Presepsin, a soluble CD14 subtype, has been proposed as a promising early marker of bacterial infection. This study aimed to assess the diagnostic value of serum presepsin in comparison with traditional inflammatory markers in neonates with suspected sepsis. Methods: In a prospective observational study conducted at a single tertiary care center, 18 neonates with clinical signs of sepsis were evaluated. The patients were divided into culture-proven (n=7) and culture-unproven (n=11) sepsis groups. Presepsin levels were measured using a chemiluminescent assay and compared to CRP, PCT, and WBC counts. Results: The median presepsin levels were higher in culture-proven cases (740 ng/L vs. 393 ng/L), but without statistical significance. Similar trends were observed for CRP and PCT, while WBC counts showed no diagnostic value. Conclusion: Although presepsin demonstrated potential as an early biomarker, its diagnostic performance in this small cohort was inconclusive. Combined use of presepsin with conventional markers and clinical evaluation may improve early sepsis diagnosis in neonates.