Procalcitonin in detecting neonatal nosocomial sepsis.

Abstract

OBJECTIVE:

To investigate the accuracy of procalcitonin (PCT) as a diagnostic marker of nosocomial sepsis (NS) and define the most accurate cut-off to distinguish infected from uninfected neonates.

SETTING:

Six neonatal intensive care units (NICUs).

PATIENTS:

762 neonates admitted to six NICUs during a 28-month observational study for whom at least one serum sample was taken on admission.

MAIN OUTCOME MEASURES:

Positive and negative predictive values at different PCT cut-off levels.

RESULTS:

The overall probability of an NS was doubled or more if PCT was >0.5 ng/ml. In very-low-birth-weight (VLBW) infants, a cut-off of >2.4 ng/ml gave a positive predictive value of NS near to 50% with a probability of a false-positive diagnosis of NS in about 10% of the patients.

CONCLUSIONS:

In VLBW neonates, a serum PCT value >2.4 ng/ml prompts early empirical antibiotic therapy, while in normal-birth-weight infants, a PCT value ≤2.4 ng/ml carries a low risk of missing an NS.

• Authors: Cinzia Auriti, Ersilia Fiscarelli, Maria Paola Ronchetti, Marta Argentieri, Gabriella Marrocco, Anna Quondamcarlo, Giulio Seganti, Francesco Bagnoli, Giuseppe Buonocore, Giovanni Serra, Gianfranco Bacolla, Savino Mastropasqua, Annibale Mari, Carlo Corchia, Giusi Prencipe, Fiammetta Piersigilli, Lucilla Ravà, Vincenzo Di Ciommo
• Journal: Archives of disease in childhood. Fetal and neonatal edition (Arch Dis Child Fetal Neonatal Ed) Vol. 97 Issue 5 Pg. F368-70 (Sep 2012) ISSN: 1468-2052 [Electronic] England
• PMID: 22933097 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• CALCA protein, human
• Protein Precursors
• Calcitonin
• Calcitonin Gene-Related Peptide

Topics

• Calcitonin (blood)
• Calcitonin Gene-Related Peptide
• Cross Infection (diagnosis)
• Humans
• Infant, Newborn
• Infant, Very Low Birth Weight
• Intensive Care Units, Neonatal
• Likelihood Functions
• Protein Precursors (blood)
• ROC Curve
• Sensitivity and Specificity
• Sepsis (diagnosis)