Reference ranges of Presepsin in preterm infants in the first 48 h of life: A multicenter observational study

Background and objectives: Despite low incidence of early-onset sepsis, the majority of preterm newborns receive early antibiotic prophylaxis. Our aim was to assess reference ranges of Presepsin during the first 48 h of life in preterm infants and to evaluate the possible influence of neonatal and maternal factors on its values. Methods: This observational study consecutively enrolled newborns ≤ 32 weeks of GA at 0–6 h of life. Enrolled infants were sampled for blood culture, complete white blood cell (WBC) count, and P-SEP at 0–6 (T₀) h of life and for P-SEP at 12 ± 3 (T₁), 24 ± 3 (T₂), and 48 ± 6 (T₃) h of life. Cases of EOS were not considered for the statistical analysis. Results: Data analysis was performed for 183 patients. P-SEP median values were 583 ng/L at T₀ (IQR 405–800 ng/L, 5th and 95th percentiles 204 and 1200 ng/L), 614 ng/L at T₁ (IQR 450–812 ng/L, 5th and 95th percentiles 262 and 1171 ng/L), 604 ng/L at T₂ (IQR 445–825 ng/L, 5th and 95th percentiles 292 and 1302 ng/L) and 513 ng/L at T₃ (IQR 371–734 ng/L, 5th and 95th percentiles 249 and 1278 ng/L). P-SEP values are negatively associated to gestational age (GA) at T₀, T₁, and T₂. Conclusions: We determined for the first time the reference ranges of P-SEP during the first 48 h of life in very preterm infants and provided its percentile distribution at T₀, T₁, T₂ and T₃. P-SEP measurement was affected by GA at T₀, T₁, T₂.