• Gabriella Bottari, Emanuel Paionni, FegatelliDanilo AlunniDADepartment of Life Sciences, Health and Helath Professions, LInk Campus University of Rome, Rome, Italy., Manuel Murciano, Francesco Rosati, Federica Ferrigno, Mara Pisani, Sebastian Cristaldi, Annamaria Musolino, Giorgia Borrelli, Chiara Bochicchio, Lorenza Romani, Maia De Luca, Marilena Agosta, Laura Lancella, Alberto Villani, Annarita Vestri, AttiMarta Ciofi DegliMCDClinical Pathways and Epidemiology Unit Medical Direction, Bambino Gesù Children's Hospital, IRCSS, Rome Italy., Carlo F Perno, Ottavia Porzio, Massimiliano Raponi, and Corrado Cecchetti.
• Pediatric Intensive Care, Bambino Gesù Children's Hospital, IRCSS, Rome, Italy.
• Pediatr Crit Care Me. 2024 Oct 1; 25 (10): 937946937-946.

ObjectivesBlood level of pancreatic stone protein (PSP) is a promising biomarker of sepsis both in adults and children. The aim of our study was to investigate the diagnostic accuracy of PSP in children with suspected sepsis and to compare diagnostic performance with other sepsis biomarkers approved for clinical use, that is, procalcitonin (PCT) and C-reactive protein (CRP).DesignProspective study.SettingPICU and pediatric emergency department.InterventionBlood levels of PSP were measured using a nanofluidic point-of-care immunoassay (abioSCOPE, Abionic SA, Switzerland) within 24 hours of admission.Measurements And Main ResultsWe studied 99 children aged between older than 1 month and younger than 18 years with signs and symptoms of systemic inflammatory response syndrome (irrespective of associated organ dysfunction). The prevalence of sepsis was 35 of 99 (35.4%). Patients with sepsis had higher PSP levels ( p < 0.001) than patients with systemic inflammation of noninfectious cause. In this analysis, the optimal cutoff for the diagnosis of sepsis using PSP was 123 ng/mL, which resulted in a sensitivity of 0.63 (95% CI, 0.43-0.80), specificity of 0.89 (95% CI, 0.77-0.95). The PSP test area under the receiver operating characteristic curve (AUROC) was 0.82 (95% CI, 0.73-0.91) and, by comparison, procalcitonin and CRP AUROC were 0.70 (95% CI, 0.58-0.82) and 0.72 (95% CI, 0.60-0.84), respectively. Overall, the pretest to posttest probability of sepsis with a positive test changed from 0.35 to 0.73.ConclusionsIn this single-center prospective pediatric cohort, admitted to the high intensive care and to the PICU, our findings suggested the potential use of PSP as a sepsis biomarker. However, because of the clinical diagnostic uncertainty with a positive result, further investigation is needed particularly in combination with other biomarkers.Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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