Diagnostic value of soluble CD14 subtype (sCD14-ST) presepsin for the postmortem diagnosis of sepsis-related fatalities

• Published in: International journal of legal medicine 2013-07, Vol.127 (4), p.799-808
• Main Authors: Palmiere, Cristian, Mussap, Michele, Bardy, Daniel, Cibecchini, Francesco, Mangin, Patrice
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Angiography; Autopsies; Bacterial infections; Biochemistry; Biomarkers; Biomarkers - analysis; Calcitonin - analysis; Calcitonin Gene-Related Peptide; Case-Control Studies; Clinical medicine; Fatalities; Female; Forensic Medicine; Forensic Pathology; Histology; Hospitals; Humans; Infant; Infections; Infectious diseases; Lipopolysaccharide Receptors - analysis; Luminescent Measurements; Male; Medical imaging; Medical Law; Medical records; Medicine; Medicine & Public Health; Middle Aged; Neuropathology; Original Article; Pericardium - chemistry; Postmortem Changes; Protein Precursors - analysis; Proteins; Sensitivity and Specificity; Sepsis; Sepsis - diagnosis; Toxicology
• ISSN: 0937-9827; 1437-1596
• DOI: 10.1007/s00414-012-0804-5

The first aim of this study was to assess the diagnostic performance of presepsin (sCD14-ST) in postmortem serum from femoral blood compared to procalcitonin (PCT) to detect sepsis-related fatalities. The second aim was to compare sCD14-ST levels found in postmortem serum to the values in pericardial fluid to investigate the usefulness of the latter as an alternative biological fluid. Two study groups were formed, a sepsis-related fatalities group and a control group. Radiology (unenhanced CT scans and postmortem angiographies), autopsies, histology, neuropathology, and toxicology as well as other postmortem biochemistry investigations were performed in all cases. Microbiological investigations on right cardiac blood were carried out exclusively in septic cases. The results of this study indicated that postmortem serum PCT and sCD14-ST levels, individually considered, allowed septic cases to be identified. Even though increases in both PCT and sCD14-ST concentrations were observed in the control cases, coherent PCT and sCD14-ST results in cases with suspected sepsis allowed the diagnosis to be confirmed. Conversely, no relevant correlation was identified between postmortem serum and pericardial fluid sCD14-ST levels in either the septic or control groups.