A study of level of procalcitonin as marker of early onset sepsis in neonates
DOI:
https://doi.org/10.18203/2349-3291.ijcp20240344Keywords:
Neonates, Early onset sepsis, ProcalcitoninAbstract
Background: Neonatal sepsis is one of the commonest causes of morbidity and mortality. It is one of the four leading causes of morbidity and mortality in India. The purpose of this study was to evaluate the levels of procalcitonin as a rapid diagnostic test, to identify those with infection as soon as possible, and to classify them into definitive, clinical, or no sepsis. The rise in Procalcitonin levels in the neonate with sepsis is very rapid. Hence, it can be used for the diagnosis of early onset neonatal sepsis. Objectives were to estimate the concentration of Procalcitonin for diagnosis of early onset neonatal sepsis and to compare the Procalcitonin levels amongst 3 categories of neonatal sepsis (definite, clinical and no sepsis).
Methods: This is a hospital based analytical prospective study.
Results: 104 babies with early onset sepsis were included in the study from the NICU in tertiary health care center. Procalcitonin is positive in 69 (66.35%) and negative in 35 (33.65%). Out of the total 69 neonates with Procalcitonin positive, 42 (60.8%) neonates are preterm and 27 (39.1%) are term neonates. Out of the total 35 neonates with Procalcitonin negative, 24 (68.5%) neonates are preterm and 11 (31.4%) are term neonates. There was no sepsis observed in 57 (54.8%) of cases, clinical sepsis was observed in 34 (32.6%) of cases and definite sepsis was observed in 13 (12.5%). The mean value of level of Procalcitonin in different categories of sepsis as determined from the data is 3.27 ng/ml in cases of No sepsis, 11.79 ng/ml in cases of clinical sepsis and 17.2 ng/ml in cases of definitive sepsis.
Conclusions: Procalcitonin has good sensitivity and hence can detect most cases of neonatal sepsis and good negative predictive value. Procalcitonin contributes more significantly to the diagnosis of newborn septicemia when paired with additional testing and helps in identifying the categories of sepsis in neonates.
References
Aggarwal R, Sarkar N, Deorari AK, Paul VK. Sepsis in the newborn. Indian J Pediatr. 2001;68(12):1143-7.
Jeeva SM, Ramesh A, Ashok KD, Vinod KP. Sepsis in the newborn. Indian J Pediatr. 2008;75:261-6.
Verganano S, Sharland M, Pkazembe A. Neonatal sepsis: an international perspective. Arch Dis Child Fetal Neonatal. 2005;90:220-4.
National Neonatal Perinatal Database, Report 2002-03. Available at: https://www.newbornwhocc.org/ pdf/HRRC-Report_2002-03.pdf. Accessed on 20 November 2023.
Singh M. Care of the Newborn. 6th ed. India: Sagar Publishers; 2004.
Betty C, Inderpreet S. Early Onset of Neonatal Sepsis. Indian J Pediatr. 2005;72:23-6.
Tallur SS, Kasturi AV, Shobha D Nadgir, Krishna BVS. Clinicobacteriological Study of neonatal septicemia in Hubli. Indian J Pediatr. 2000;67(3):169-74.
Raghavan M, Mondal GP, Bhatt V, Srinivasan S. Perinatal risk factors in neonatal infections. Indian J Pediatr. 1992;59;335-440.
Roy I, Jain A, Kumar M, Agarwal SK. Bacteriology of neonatal septicemia in a Tertiary care Hospital of Northern India. Indian J Med Microbiol. 2002;20(3): 156-9.
Nawshad ASM, Azad MAK, Mahbul H, Darmstadt GL. Clinical and bacteriological profile of neonatal septicemia in a tertiary level Pediatric Hospital in Bangladesh. Indian Pediatr. 2002;39:1034-8.
Gerdes JS, Polin R. Early diagnosis and treatment of neonatal sepsis. Indian J Pediatr. 1998;65:63-71.
Abida M, Hasani SE, Khan HM, Ahmed AJ. Nosocomial infections in newborn. Indian Pediatr. 2001;38:68-71.
Kilbride HW, Powers R, Wirtschafter DD, Sheehan MB. Evaluation and development of potentially better practices to prevent neonatal Nosocomial bacteremia. Pediatrics. 2003;111:e504-18.
Kuruvilla KA, Pillai S, Jesudason M. Bacterial Profile of Sepsis in a Neonatal unit in South India. Indian Pediatr. 1998;35:851-8.
Bhattacharya S. Blood culture in India: a proposal for a national programme for early detection of sepsis. Indian J Med Microbiol. 2005;23:220-6.
