Procalcitonin as a Diagnostic Marker of Sepsis in Neonates

Abstract

Objective: To determine the diagnostic accuracy of serum procalcitonin levels (PCT) by  taking  blood culture as gold standard.

Methods: This was a cross-sectional study  conducted  in  neonatal  intensive  care  unit  (NICU)  of  Liaquat National Hospital, Karachi over a period of six months from June 2017 to December 2017. A total of 141 babies were enrolled in the study that had evidence of neonatal sepsis. Non-probability consecutive sampling was the technique used in our study for sample collection.  Later  on,  after  completion of data of required sample, a data base was developed on SPSS for windows version 22.0 for data analysis. Mean, median and standard deviation were calculated for continuous while fre- quency along with percentages was drawn for qualitative variables. Pearson Chi-square test (c2) was applied on all qualitative variables by taking p-value <0.05 as significant. Finally, the diagnostic accuracy of serum procalcitonin levels in neonatal sepsis was calculated in terms of sensitivity, specificity, positive predictive values and  negative  predictive  values  using  blood  culture  as  gold  standard. 

Results: Of 141 neonates, 68 were males and 73 were females which constitutes 48.2% and 51.8%, respectively. The mean weight of neonates was 2.49 ± 0.55 kg, while mean height and FOC (frontal- occipital circumference) were found to be 46.22 ± 3.17 cm and 33.29 ± 1.41 cm, respectively.  The sensitivity of PCT in this study was found to  be  70.90%  while  the  specificity  was  77.90%.  Further-  more, positive predictive value (PPV) and negative predictive value (NPV) accounted for 67.24% and 80.72%, respectively.

Conclusion: Although blood culture is the gold standard method to diagnose neonatal sepsis in neo-   nates, however PCT has also shown good accuracy with quick results in diagnosing neonatal sepsis in this study. The early use of PCT in neonatal infection may definitely help us limiting number of neonates putting on antibiotics due to suspected risk of infection.