Biochemical Markers for the Early Assessment of Neonatal Sepsis: the Role of Procalcitonin (original) (raw)
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Procalcitonin as a Marker of Neonatal Sepsis
Iranian Journal of Pediatrics, 2009
Objective: Early diagnosis of neonatal sepsis and appropriate treatment decreases the mortality and morbidity of these infants. The aim of this study was to assess the role of pro‐ calcitonin (PCT) as a marker in the early diagnosis, treatment and follow‐up of neonatal sepsis. Methods: Thirty‐eight neonates with clinical (n=8), suspected (n=19) and proven sepsis (n=11) were evaluated. The PCT levels were measured by immunoluminoassay before and on day 5 of treatment. PTC levels of 0.5‐2 ng/ml, 2.1‐10 ng/ml and >10 ng/ml were considered as weakly positive, positive, and strongly positive, respectively. The sepsis screen tests and cultures of blood or other sterile body fluids in these three groups of infants were recorded. Findings: The levels of PCT in proven sepsis group were higher than that in other groups. Strongly positive PTC level was seen in none of 8 cases of clinical sepsis, 4 of 19 suspected and in 10 of 11 cases with proven sepsis. PCT levels were dramatically decreas...
Diagnostic value of procalcitonin in neonatal sepsis
Nigerian Journal of Paediatrics, 2016
Introduction: Neonatal sepsis is a major cause of mortality in developing countries. Accurate and quick diagnosis are difficult because clinical presentation are non-specific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. Serum procalcitonin (PCT) has been proposed as an early marker of infections in neonates. Objectives: This study investigated the value of PCT in the diagnosis of Neonatal Sepsis. Methods: Neonates undergoing sepsis evaluation at the Special Baby Care Unit, Federal Medical Centre, Abeokuta, Nigeria between January and April 2013 were included. Blood samples were obtained for white cell count, blood cultures, serum CRP and PCT analysis. Neonates were categorised into Proven Sepsis, Suspected Sepsis and Clinical Sepsis groups on the basis of laboratory findings and risk factors. A control group with no clinical and biological data of infection was also included. Predictive values and area under the receiver operating characteristic curve (AUC) of PCT were evaluated. Result: Of the 85 neonates, 19 (22.4%) had positive blood culture. PCT level was significantly higher in neonates in all sepsis groups in comparison with those in the control group (P< 0.05). At a cutoff of 0.5 ng/ml, the negative predictive value (NPV) of PCT was 80% and the positive predictive value (PPV) 39%. There were no significant statistical difference between the AUC values of PCT in Early onset and Late onset sepsis, as well between AUC in Preterm and term cases. A higher percentage of neonates who died (96%) had elevated PCT levels compared to those who survived (46%). Conclusion: These findings support the usefulness of the PCT in diagnosis of Neonatal sepsis.
Significance of Serum Procalcitonin Level in the Early Diagnosis of Neonatal Sepsis
2020
Background: Sepsis in neonates presents itself with non-specific clinical features which makes early diagnosis difficult. However, procalcitonin (PCT) and other inflammatory markers have recently been considered as sensitive markers for the early detection of neonatal sepsis. Therefore, the present study aimed to determine the diagnostic value of PCT in the early detection of neonatal sepsis and compare it with C-reactive protein (CRP) and white blood cells count.Methods: This case-control study was conducted on 40 neonates who were divided into two groups. The case or sepsis group consisted of 18 neonates with the clinical symptoms of sepsis and positive culture. On the other hand, the control group contained 22 healthy neonates with negative culture. Demographic characteristic of all the participants was recorded during the clinical follow-up. Moreover, blood samples were collected from each neonate for hematological analysis, blood culture, serum CRP measurement, and PCT analysis...
Sensitivity and specificity of procalcitonin in diagnosis of neonatal sepsis
Iranian Journal of …, 2008
Background and Objective: According to the fact that neonatal infection is a challenging diagnosis field, several studies have tried to test sensitivity and specificity of diagnostic tests. This study was conducted to evaluate the sensitivity and specificity of procalcitonin (PCT) as a single early marker of neonatal sepsis. Materials and Methods: In this study, 150 neonates admitted to NICU and neonatal ward in Shahrekord Hajar hospital were enrolled. A full workup including blood cultureand other tests and PCT was conductede. Sensitivity, specificity, positive and negative predictive values for PCT was determined. Results: It was found out that 8 patients had definite infection, 15 patients had possible infection, and 127 patients had no infection. Although PCT was not able to significantly differentiate between those with definite and possible infections (p>0.05), but there was a significant difference for frequency of abnormal PCT between non-infectious patients and other patients. Sensitivity, specificity, positive and negative predictive values of PCT was 87.5%, 87.4%, 30.4%, 99.1%, and 87.41% respectively. Conclusion: Beside the limitation of the sample size, the satisfactory diagnostic characteristics of PCT highlight it as a good measure for diagnosis of neonatal sepsis. Further studies are essential to be carried out.
Umbilical cord serum procalcitonin, as an early diagnostic marker of early neonatal sepsis
Caspian Journal of Pediatrics (CJP), 2021
Background and Objective: The prognosis of early neonatal sepsis is significantly associated with rapid diagnosis and appropriate antibiotic therapy. Since blood culture has been reported positive in less than 16% of neonatal sepsis cases, various biochemical markers have been evaluated. This study was performed to evaluate the umbilical cord blood procalcitonin (PCT) as an early diagnostic marker of early neonatal sepsis. Methods: This cross-sectional study included 100 neonates in two groups of case and control. The case group consisted of three separate groups, including proven, suspected and clinical sepsis groups. The PCT level of umbilical cord blood was measured by immunoluminoassay method, and PCT 0.5-2ng/ml, 2-10 ng/ml and >10ng/ml were considered weakly positive, positive and strongly positive, respectively. Sepsis screening tests and a culture taken from blood or other sterile fluids were studied in the case group. Findings: The PCT mean was 1.39±1.52 and 0.17±0.05ng/ml in the case (sepsis) and control groups, respectively. Finally, the PCT level was significantly higher in all cases in the proven sepsis group than in other sepsis groups. Conclusion: The result of this study showed that the mean value of PCT level in umbilical cord blood was higher in the sepsis group, and it was higher in the proven sepsis group than in the other two groups of sepsis.
Serum procalcitonin as an early marker of neonatal sepsis
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2004
It has recently been suggested that procalcitonin (PCT) is of value in the diagnosis of neonatal sepsis, with varying results. This study was to evaluate the role of PCT as a single early marker of neonatal sepsis. Neonatal Unit, Johannesburg Hospital, and Microbiology Laboratory, National Health Laboratory Service (NHLS), South Africa. Neonates undergoing evaluation for sepsis between April and August 2002 were eligible for inclusion. Patients were categorised into 'no infection', 'possible infection' and 'definite infection' on the basis of C-reactive protein (CRP), white cell count (WCC), platelet count and blood culture results. PCT was correlated with infection categories. One hundred and eighty-three neonates were enrolled. One hundred and eighteen had no infection, 52 possible infection and 13 definite infection. PCT differed significantly among infection categories (p < 0.0001) and correlated significantly with CRP at presentation (correlation coef...
Intensive Care Medicine, 2011
Purpose: To assess the value of serum procalcitonin (PCT) for the differentiation between patients with and without neonatal sepsis. Methods: We systematically searched PubMed, Scopus, and the Cochrane Library for studies evaluating PCT in neonatal sepsis. PCT had to be measured in neonatal blood samples, at the initial presentation of patients with suspected sepsis, before the administration of antibiotics. We performed a bivariate meta-analysis of sensitivity and specificity, and constructed a hierarchical summary receiver-operating characteristic (HSROC) curve. Results: Overall, 29 studies eligible for inclusion were identified. We analyzed the 16 studies (involving 1,959 neonates) that evaluated PCT in neonates with cultureproven or clinically diagnosed sepsis in comparison with ill neonates with other conditions. The pooled (95% confidence interval) sensitivity and specificity were 81% (74-87%) and 79% (69-87%), respectively. The area under the HSROC curve (AUC) was 0.87. The diagnostic accuracy of PCT seemed higher for neonates with late-onset sepsis ([72 h of life) than for those with early onset sepsis; the AUC for these analyses was 0.95 and 0.78, respectively. However, fewer data were available for late-onset sepsis. High statistical heterogeneity was observed for all analyses. Conclusion: Our findings suggest that serum PCT at presentation has very good diagnostic accuracy (AUC = 0.87) for the diagnosis of neonatal sepsis. However, in view of the marked observed statistical heterogeneity, along with the lack of a uniform definition for neonatal sepsis, the interpretation of these findings should be done with appropriate caution.