Significance of Serum Procalcitonin Level in the Early Diagnosis of Neonatal Sepsis

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. Finally, all the collected data were statistically analyzed in SPSS software (version 17).Results: Based on the findings, the mean value of the procalcitonin level was significantly higher in the sepsis group (866.60±480.51 pg/ml), compared with that of the control group (P<0.001). Moreover, the CRP was positive in 66.7% of sepsis patients and 22.7% of the control group (P=0.006). The procalcitonin level shows higher sensitivity (94%) than CRP (66%) with the same specificity but a higher positive and negative predictive value.Conclusion: Procalcitonin level was elevated in neonates with sepsis in comparison to normal neonates and it is more sensitive than CRP. The PCT could be used as a routine test for the early diagnosis of neonatal sepsis which also leads to a reduction in the use of antibiotics.

Keywords:

C-reactive protein , diagnosis of sepsis , Neonatal sepsis , Procalcitonin