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Can we rely on procalcitonin in the diagnosis of late onset neonatal sepsis?
  1. N Athiraman,
  2. R Agarwal,
  3. S Krishnamoorthy,
  4. M Guy
  1. Salford Royal Hospitals NHS Foundation Trust, Salford, UK

Abstract

Aims (1) To explore the usefulness of procalcitonin (PCT) assay in the diagnosis of late onset neonatal sepsis (LONS). (2) To compare the diagnostic usefulness of PCT with C reactive protein (CRP).

Methods Infants ≥ 48 h old and being investigated for LONS were recruited after informed consent. The sepsis episodes were categorised into three groups: true positive, true negative and possible sepsis on the basis of clinical symptoms, results from blood culture or other sterile body fluids and raised CRP or thrombocytopenia.

Results A total of 219 sepsis episodes in 121 infants were evaluated. There were 79 (36%) true positive, 68 (31%) possible sepsis and 71 (33%) true negative episodes of sepsis. The sensitivity and specificity were calculated for true positive versus true negative episodes; and the cut-off used for CRP and PCT was 10 and 0.5 respectively. The sensitivity of PCT and CRP was 68% and 56% respectively whereas the specificity was 60% and 85% (table 1).

View this table:
ABSTRACT PF.07 Table 1

Diagnostic tests: Procalcitonin vs CRP

Conclusion PCT is a useful marker of LONS. In this study, PCT is more sensitive but less specific than CRP in the diagnosis of LONS. PCT could be used as a useful adjuvant to CRP in the evaluation of LONS.

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