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Objective This study aimed to investigate the diagnostic value of presepsin, a new inflammatory marker for paediatric appendicitis, and to determine a reference range of presepsin for children. Methods This single-center prospective study was conducted in our paediatric emergency department between 1 February 2021 and 1 July 2021. Patients aged 0–18 years diagnosed with acute appendicitis, which was pathologically confirmed, and healthy volunteers in the same age group were included in the study. Serum presepsin levels were analysed using an enzyme-linked immunosorbent assay reader. In addition to presepsin, other acute-phase reactants, paediatric appendicitis scores and imaging methods were evaluated. Results There were 94 patients in the acute appendicitis group and 102 healthy volunteers in the control group. Median values were compared between the two groups, and no statistically significant differences were found (p = 0.544). In addition, no statistically signivficant differences in presepsin levels were found between the acute and perforated appendicitis groups (p = 0.344). The median (IQ1–IQ3) reference range for presepsin in healthy children was 0.9950 (0.7575–1.610) ng/mL. Conclusion Presepsin is not a suitable marker for the diagnosis of acute appendicitis. We observed that serum presepsin levels were not elevated in paediatric appendicitis, which is a local infection, in contrast to previous studies.

Sepsis is a major healthcare problem worldwide. Its mortality and morbidity is still high. Early diagnosis of sepsis and appropriate management in the initial hours improve outcomes. The Surviving Sepsis Campaign published new definitions for sepsis in 2016. In Sepsis-3 definitions, sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction can be identified as an acute change in total SOFA score of at least two points consequent to the infection. However, this definition is endorsed by two international societies and there is much discussion regarding new definitions. Prospective validation of this definition on different levels is needed. The infectious source in sepsis depends on patients' underlying diseases and origin of the infection (community-acquired or healthcare-associated). In the literature, urinary tract and skin-soft tissue infection are the common sites in community-acquired sepsis, whereas respiratory system and intraabdominal infections are more common in nosocomial sepsis. Another challenge in sepsis management is the increasing incidence of sepsis due to multidrug-resistant bacteria and limited treatment options. New antibiotics may be treatment options in the future. In this review, current definitions of sepsis, physiopathology of sepsis, foci of sepsis and causative microorganisms, microbiological diagnosis and rapid diagnosis methods, biomarkers used in the diagnosis of sepsis, antimicrobial treatment and resistance, new antibiotics and non-antibiotic therapy are discussed.