Diagnostic Value of Procalcitonin in Neonatal Sepsis

ABSTRACT

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 cut-off 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