Procalcitonin as a marker for the early diagnosis of neonatal infection,☆☆,,★★

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Abstract

Serum procalcitonin was determined in newborn infants at the time of admission to the pediatrics or obstetrics unit. Increased levels were found in all neonates with bacterial sepsis. Neonates with viral infection, bacterial colonization, or neonatal distress had normal or slightly increased levels. These data suggest that procalcitonin might be of value in diagnosing neonatal sepsis. (J PEDIATR 1996;128:570-3)

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METHODS

In a prospective study, 177 newborn infants were enrolled from the pediatrics or obstetrics unit in Saint Vincent de Paul Hospital in Paris. The study protocol was approved by the ethics committee of Paris-Cochin Medical School. All the nonpremature infants (from birth to age 15 days; gestational age >32 weeks) were included in the study group if blood samples were available after routine studies had been completed. Blood samples were collected at the time of admission and before the first

RESULTS

The distributions of proCT and CRP concentrations in each group of neonates are shown in the Figure. In the control group, the proCT levels were less than 0.71 μg/L. The CRP values measured in 68 of the 86 control infants were less than 8 mg/L in 63 infants and between 8 and 14 mg/L in 5. Of 50 infants with neonatal distress, 48 had proCT levels more than or equal to 0.40 μg/L on admission and 2 had increased values of 2.70 and 2.80 μg/L, respectively. The CRP levels in this group were less

DISCUSSION

The data demonstrate very high serum proCT levels in all neonates with proven or clinically diagnosed bacterial infection. Neonates with viral infection, bacterial colonization, or neonatal distress of numerous causes, including hypoxemia, had normal or only slightly increased proCT serum levels. The demonstration of high proCT concentrations associated with sepsis caused by a variety of infections has been recently described in reports on adults.1, 2, 3, 6 In addition, endotoxin has been shown

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From the Département de Pédiatrie and Laboratoire de Microbiologie, Hôpital Saint-Vincent-de-Paul, Paris, and the Département de Biologie clinique, Institut Gustave-Roussy, Villejuif, France

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Supported in part by a grant (940050) from the Assistance Publique-Hôpitaux de Paris.

Reprint requests: Claude Bohuon, PhD, Departement de Biologie Clinique, Institut Gustave-Roussy, 94805 Villejuif, France.

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0022-3476/96/$5.00 + 0 9/22/71213

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