Circulating presepsin (soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock: data from the multicenter, randomized ALBIOS trial

Serge Masson, Pietro Caironi, Caterina Fanizza, Ralf Thomae, Roberto Bernasconi, Andrea Noto, Roberto Oggioni, Giovanni Stefano Pasetti, Marilena Romero, Gianni Tognoni, Roberto Latini, Luciano Gattinoni

Research output: Contribution to journalArticle

Abstract

Purpose: Presepsin is a soluble fragment of the cluster-of-differentiation marker protein 14 (CD14) involved in pathogen recognition by innate immunity. We evaluated the relation between its circulating concentration, host response, appropriateness of antibiotic therapy, and mortality in patients with severe sepsis.

Methods: Plasma presepsin was measured 1, 2, and 7 days after enrollment of 997 patients with severe sepsis or septic shock in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial. They were randomized to albumin or crystalloids. We tested with univariate and adjusted models the association of single measurements of presepsin or changes over time with clinical events, organ dysfunctions, appropriateness of antibiotic therapy, and ICU or 90-day mortality.

Results: Presepsin concentration at baseline (946 [492–1,887] ng/L) increased with the SOFA score, the number of prevalent organ dysfunctions or failures, and the incidence of new failures of the respiratory, coagulation, liver, and kidney systems. The concentration decreased in ICU over 7 days in patients with negative blood cultures, and in those with positive blood cultures and appropriate antibiotic therapy; it increased with inappropriate antibiotic therapy (p = 0.0009). Baseline presepsin was independently associated with, and correctly reclassified, the risk of ICU and 90-day mortality. Increasing concentrations of presepsin from day 1 to day 2 predicted higher ICU and 90-day mortality (adjusted p 

Conclusions: Presepsin is an early predictor of host response and mortality in septic patients. Changes in concentrations over time seem to reflect the appropriateness of antibiotic therapy.

Original languageEnglish
Pages (from-to)12-20
Number of pages9
JournalIntensive Care Medicine
Volume41
Issue number1
DOIs
Publication statusPublished - Dec 13 2014

Fingerprint

Septic Shock
Albumins
Sepsis
Anti-Bacterial Agents
Mortality
CD Antigens
Therapeutics
Innate Immunity
Respiratory Insufficiency
Kidney
Liver
Incidence
Proteins
Blood Culture

Keywords

  • Clinical trial
  • Presepsin
  • Prognosis
  • Septic shock
  • Severe sepsis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

Circulating presepsin (soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock : data from the multicenter, randomized ALBIOS trial. / Masson, Serge; Caironi, Pietro; Fanizza, Caterina; Thomae, Ralf; Bernasconi, Roberto; Noto, Andrea; Oggioni, Roberto; Pasetti, Giovanni Stefano; Romero, Marilena; Tognoni, Gianni; Latini, Roberto; Gattinoni, Luciano.

In: Intensive Care Medicine, Vol. 41, No. 1, 13.12.2014, p. 12-20.

Research output: Contribution to journalArticle

Masson, S, Caironi, P, Fanizza, C, Thomae, R, Bernasconi, R, Noto, A, Oggioni, R, Pasetti, GS, Romero, M, Tognoni, G, Latini, R & Gattinoni, L 2014, 'Circulating presepsin (soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock: data from the multicenter, randomized ALBIOS trial', Intensive Care Medicine, vol. 41, no. 1, pp. 12-20. https://doi.org/10.1007/s00134-014-3514-2
Masson, Serge ; Caironi, Pietro ; Fanizza, Caterina ; Thomae, Ralf ; Bernasconi, Roberto ; Noto, Andrea ; Oggioni, Roberto ; Pasetti, Giovanni Stefano ; Romero, Marilena ; Tognoni, Gianni ; Latini, Roberto ; Gattinoni, Luciano. / Circulating presepsin (soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock : data from the multicenter, randomized ALBIOS trial. In: Intensive Care Medicine. 2014 ; Vol. 41, No. 1. pp. 12-20.
@article{839bf06aeec040abb8ae9e5b14a22895,
title = "Circulating presepsin (soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock: data from the multicenter, randomized ALBIOS trial",
abstract = "Purpose: Presepsin is a soluble fragment of the cluster-of-differentiation marker protein 14 (CD14) involved in pathogen recognition by innate immunity. We evaluated the relation between its circulating concentration, host response, appropriateness of antibiotic therapy, and mortality in patients with severe sepsis.Methods: Plasma presepsin was measured 1, 2, and 7 days after enrollment of 997 patients with severe sepsis or septic shock in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial. They were randomized to albumin or crystalloids. We tested with univariate and adjusted models the association of single measurements of presepsin or changes over time with clinical events, organ dysfunctions, appropriateness of antibiotic therapy, and ICU or 90-day mortality.Results: Presepsin concentration at baseline (946 [492–1,887] ng/L) increased with the SOFA score, the number of prevalent organ dysfunctions or failures, and the incidence of new failures of the respiratory, coagulation, liver, and kidney systems. The concentration decreased in ICU over 7 days in patients with negative blood cultures, and in those with positive blood cultures and appropriate antibiotic therapy; it increased with inappropriate antibiotic therapy (p = 0.0009). Baseline presepsin was independently associated with, and correctly reclassified, the risk of ICU and 90-day mortality. Increasing concentrations of presepsin from day 1 to day 2 predicted higher ICU and 90-day mortality (adjusted p Conclusions: Presepsin is an early predictor of host response and mortality in septic patients. Changes in concentrations over time seem to reflect the appropriateness of antibiotic therapy.",
keywords = "Clinical trial, Presepsin, Prognosis, Septic shock, Severe sepsis",
author = "Serge Masson and Pietro Caironi and Caterina Fanizza and Ralf Thomae and Roberto Bernasconi and Andrea Noto and Roberto Oggioni and Pasetti, {Giovanni Stefano} and Marilena Romero and Gianni Tognoni and Roberto Latini and Luciano Gattinoni",
year = "2014",
month = "12",
day = "13",
doi = "10.1007/s00134-014-3514-2",
language = "English",
volume = "41",
pages = "12--20",
journal = "Intensive Care Medicine",
issn = "0342-4642",
publisher = "Springer Verlag",
number = "1",

}

TY - JOUR

T1 - Circulating presepsin (soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock

T2 - data from the multicenter, randomized ALBIOS trial

AU - Masson, Serge

AU - Caironi, Pietro

AU - Fanizza, Caterina

AU - Thomae, Ralf

AU - Bernasconi, Roberto

AU - Noto, Andrea

AU - Oggioni, Roberto

AU - Pasetti, Giovanni Stefano

AU - Romero, Marilena

AU - Tognoni, Gianni

AU - Latini, Roberto

AU - Gattinoni, Luciano

PY - 2014/12/13

Y1 - 2014/12/13

N2 - Purpose: Presepsin is a soluble fragment of the cluster-of-differentiation marker protein 14 (CD14) involved in pathogen recognition by innate immunity. We evaluated the relation between its circulating concentration, host response, appropriateness of antibiotic therapy, and mortality in patients with severe sepsis.Methods: Plasma presepsin was measured 1, 2, and 7 days after enrollment of 997 patients with severe sepsis or septic shock in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial. They were randomized to albumin or crystalloids. We tested with univariate and adjusted models the association of single measurements of presepsin or changes over time with clinical events, organ dysfunctions, appropriateness of antibiotic therapy, and ICU or 90-day mortality.Results: Presepsin concentration at baseline (946 [492–1,887] ng/L) increased with the SOFA score, the number of prevalent organ dysfunctions or failures, and the incidence of new failures of the respiratory, coagulation, liver, and kidney systems. The concentration decreased in ICU over 7 days in patients with negative blood cultures, and in those with positive blood cultures and appropriate antibiotic therapy; it increased with inappropriate antibiotic therapy (p = 0.0009). Baseline presepsin was independently associated with, and correctly reclassified, the risk of ICU and 90-day mortality. Increasing concentrations of presepsin from day 1 to day 2 predicted higher ICU and 90-day mortality (adjusted p Conclusions: Presepsin is an early predictor of host response and mortality in septic patients. Changes in concentrations over time seem to reflect the appropriateness of antibiotic therapy.

AB - Purpose: Presepsin is a soluble fragment of the cluster-of-differentiation marker protein 14 (CD14) involved in pathogen recognition by innate immunity. We evaluated the relation between its circulating concentration, host response, appropriateness of antibiotic therapy, and mortality in patients with severe sepsis.Methods: Plasma presepsin was measured 1, 2, and 7 days after enrollment of 997 patients with severe sepsis or septic shock in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial. They were randomized to albumin or crystalloids. We tested with univariate and adjusted models the association of single measurements of presepsin or changes over time with clinical events, organ dysfunctions, appropriateness of antibiotic therapy, and ICU or 90-day mortality.Results: Presepsin concentration at baseline (946 [492–1,887] ng/L) increased with the SOFA score, the number of prevalent organ dysfunctions or failures, and the incidence of new failures of the respiratory, coagulation, liver, and kidney systems. The concentration decreased in ICU over 7 days in patients with negative blood cultures, and in those with positive blood cultures and appropriate antibiotic therapy; it increased with inappropriate antibiotic therapy (p = 0.0009). Baseline presepsin was independently associated with, and correctly reclassified, the risk of ICU and 90-day mortality. Increasing concentrations of presepsin from day 1 to day 2 predicted higher ICU and 90-day mortality (adjusted p Conclusions: Presepsin is an early predictor of host response and mortality in septic patients. Changes in concentrations over time seem to reflect the appropriateness of antibiotic therapy.

KW - Clinical trial

KW - Presepsin

KW - Prognosis

KW - Septic shock

KW - Severe sepsis

UR - http://www.scopus.com/inward/record.url?scp=84918543908&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84918543908&partnerID=8YFLogxK

U2 - 10.1007/s00134-014-3514-2

DO - 10.1007/s00134-014-3514-2

M3 - Article

C2 - 25319385

AN - SCOPUS:84918543908

VL - 41

SP - 12

EP - 20

JO - Intensive Care Medicine

JF - Intensive Care Medicine

SN - 0342-4642

IS - 1

ER -