ORIGINAL ARTICLES

Rapid quantitative procalcitonin measurement to diagnose nosocomial infections in newborn infants

A Jacquot¹, J-M Labaune², T-P Baum³, G Putet², J-C Picaud¹

¹ CHU de Montpellier, Service de Réanimation Néonatale, Hôpital Arnaud de Villeneuve, Montpellier, France
² CHU de Lyon, Service de Réanimation Néonatale, Hôpital de la Croix-Rousse, Lyon, France
³ CHU de Montpellier, Département d’Information Médicale, Hôpital Arnaud de Villeneuve, Montpellier, France

^{Correspondence to} Dr Aurélien Jacquot, Service de Néonatologie (Pédiatrie 2), CHU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France; a-jacquot{at}chu-montpellier.fr

Background and objective: Serum procalcitonin (PCT) monitoring may help clinicians to manage nosocomial infections in neonates. This study investigated the diagnostic value of a new, rapid method to measure PCT and sought to determine the best cut-off value.

Methods: This monocentric, prospective study included all newborn infants with clinical suspicion of infection in a neonatal intensive care unit. Rapid, automated PCT measurements were performed on blood samples obtained for C-reactive protein (CRP) measurement. Negative and positive predictive values, sensitivity and specificity were calculated. Logistic regression analysis determined the best cut-off value to obtain a negative predictive value of PCT that was at least 15% above that of CRP.

Results: Between June 2005 and May 2006, 73 newborn infants with a median (Q25–Q75) gestational age of 28 (26–30) weeks and a birth weight of 995 (720–1350) g were included. Thirty (41%) were infected. The best PCT cut-off value was 0.6 ng/ml, which provided a negative predictive value of 100%. The sensitivity, specificity and positive predictive value were 100%, 65%, and 67%, respectively, for PCT at the 0.6 ng/ml cut-off value.

Conclusion: Rapid measurement of PCT could help to rule out nosocomial infection in newborn infants hospitalised in intensive care units.

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The exact negative predictive value of procalcitonin remains to be determined

Pieter L.J. Degraeuwe

Fetal Neonatal Ed. Online, 27 Oct 2009 [Full text]