Study of procalcitonin in neonatal sepsis with blood culture in suspected sepsis in North India
Keywords:Blood culture, Neonatal sepsis, Procalcitonin, Suspected sepsis
Background: Sepsis can occasionally be difficult to demonstrate, and its difference from non-infectious conditions in critically ill patients is often a challenge. Serum procalcitonin (PCT) assay is one of the biomarkers of sepsis. The aim of the study was to investigate the value of procalcitonin, in the early diagnosis of neonatal sepsis.
Methods: A cross-sectional study was conducted at tertiary care hospital in New Delhi. It included all neonates with clinical signs of sepsis. The neonates were divided into two groups as sepsis, and healthy neonates. The PCT level was measured by using ELISA technique and compared between the two groups. Statistical analysis was performed using SPSS windows version 20.0 software.
Results: In this study total number of patients included 350, out of which 175 were clinically suspected sepsis cases and 175 were healthy controls. 68 (39%) neonates were show positive blood culture and 107 (61%) neonates were representing negative blood culture report in study group. The mean serum value of PCT was significantly (p<0.001) higher in sepsis neonates. The serum PCT value was significantly increased in neonate’s sepsis with positive blood culture (p<0.001) and negative blood culture (p<0.001) as compared to healthy neonates.
Conclusions: It is concluded from this study that the PCT assay was established to be a valuable biomarker of sepsis in this study. The assay might be performed and reported quickly and gave precious information before availability of culture results. This might assist in avoiding unnecessary antibiotic therapy.
Muller B, Schuetz P, Trampuz A. Circulating biomarkers as surrogates for bloodstream infections. Int J Antimicrob Agents. 2007;30(1):16-23.
Muller B, Becker KL, Schachinger H, Rickenbacher PR, Huber PR, Zimmerli W, et al. Calcitonin precursors are reliable markers of sepsis in a medical intensive care unit. Crit Care Med. 2000;28(4):977-83.
American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med. 1992;20(6):864-74.
Sachdeva A, Yadav SP, Anjan M, Srivastava LM, Kharya G. Serial measurement of interleukin-6 and procalcitonin for determination of bacterial sepsis and outcome in children with febrile neutropenia. J Clin Oncol. 2008;26:20633.
Singh JC, Kekre NS. Procalcitonin: A marker of renal parenchymal infection in children?. Indian J Urol. 2006;22:162-3.
Shafiq N, Malhotra S, Bhasin DK, Rana S, Siddhu S, Pandhi P. Estimating the diagnostic accuracy of procalcitonin as a marker of the severity of acute pancreatitis: a meta-analytic approach. JOP. 2005;6(3):231-7.
Hatherill M, Tibby SM, Turner C, Ratnavel N, Murdoch IA. Procalcitonin and cytokine levels: relationship to organ failure and mortality in pediatric septic shock. Crit Care Med. 2000;28(7):2591-4.
Aouifi A, Piriou V, Bastien O, Blanc P, Bouvier H, Evans R, Celard M, et al. Usefulness of procalcitonin for diagnosis of infection in cardiac surgical patients. Crit Care Med. 2000;28(9):3171-6.
Suprin E, Camus C, Gacouin A, Tulzo Y, Lavoue S, Feuillu A, Thomas R. Procalcitonin: a valuable indicator of infection in a medical ICU?. Intensive Care Med. 2000;26(9):1232-8.
Chiesa C, Panero A, Rossi N, Stegagno M, Giusti M, Osborn JF, et al. Reliability of procalcitonin concentrations for the diagnosis of sepsis in critically ill neonates. Clin Infect Dis. 1998;26(3):664-72.
Vincent JL. Procalcitonin: The marker of sepsis? Crit Care Med. 2000;28(4):1226-8.
Athhan F, Akagunduz B, Genel F, Bak M, Can D. Procalcitonin: a marker of neonatal sepsis. J Trop Pediatr. 2002;48(1):10-4.
Carrol ED, Newland P, Riordan FA, Thomson AP, Curtis N, Hart CA. Procalcitonin as a diagnostic marker of meningococcal disease in children presenting with fever and a rash. Arch Dis Child. 2002;86(4):282-5.
Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohuon C. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet. 1993;341(8844):515-8.
Whicher J, Bienvenu J, Monneret G. Procalcitonin as an acute phase marker. Ann Clin Biochem. 2001;38(5):483-93.
Vigushin DM, Pepys MB, Hawkins PN. Metabolic and scintigraphic studies of radioiodinated human C-reactive protein in health and disease. J Clin Invest. 1993;91(4):1351-7.
Sastre JB, Perez SD, Roques SV, Fernandez CB, Coto CGD, Krauel VX, et al. Procalcitonin is not sufficiently reliable to be the sole marker of neonatal sepsis of nosocomial origin. BMC Pediatr. 2006;6:16.
Auriti C, Fiscarelli E, Ronchetti MP, Argentieri M, Marrocco G, Quondamcarlo A, et al. Procalcitonin in detecting neonatal nosocomial sepsis. Arch Dis Child Fetal Neonatal Ed. 2012;97(5):368-70.
Janota J, Stranak Z, Belohlavkova S, Mudra K, Simak J. Postnatal increase of procalcitonin in premature newborns is enhanced by chorioamnionitis and neonatal sepsis. Eur J Clin Invest. 2001;31:978-83.
Park IH, Lee SH, Yu ST, Oh YK. Serum procalcitonin as a diagnostic marker of neonatal sepsis. Korean J Pediatr. 2014;57(10):451-6.