Procalcitonin vs C-reactive protein as diagnostic biomarkers for sepsis in preterm very low birth weight neonates

Nikhil Arora; Amanpreet Sethi; Gurmeet Kaur; Shashi Kant Dhir; Varun Kaul; Jaskirat Kaur Sandhu; Ram Lal Gakhar

doi:10.18203/2349-3291.ijcp20263301

Authors

Nikhil Arora Department of Pediatrics, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India https://orcid.org/0000-0002-4127-6009
Amanpreet Sethi Department of Pediatrics, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India https://orcid.org/0000-0002-3108-0694
Gurmeet Kaur Department of Pediatrics, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
Shashi Kant Dhir Department of Pediatrics, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
Varun Kaul Department of Pediatrics, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
Jaskirat Kaur Sandhu Department of Pediatrics, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
Ram Lal Gakhar Department of Pediatrics, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20263301

Keywords:

Neonatal sepsis, C-reactive protein, Blood culture, Procalcitonin

Abstract

Background: Few studies have compared use of procalcitonin (PCT) and C-reactive protein (CRP) in diagnosis of sepsis in preterm very low birth weight neonates (VLBW). This study aimed to compare sensitivity and specificity of PCT and CRP in predicting sepsis in preterm VLBW neonates and also to compare their levels in gram positive and negative sepsis, as well as in early and late onset sepsis.

Methods: This prospective comparative study included 50 preterm very low birth weight neonates (gestational age <37 weeks and birth weight <1500 grams) with suspected neonatal sepsis. After enrollment, 1 ml of blood was collected for blood culture in Brain Heart Infusion (BHI) broth medium, and another 1 ml was collected for PCT and CRP quantitative determination with Boditech Ichroma^TM kits in Biochemistry lab using fluorescence Immunoassay. Other sepsis screen parameters, including Total Leucocyte Count (TLC), Absolute Neutrophil count (ANC), Immature-to-Total (I:T) Neutrophil ratio were also assessed. Cut-off values for CRP and PCT was taken as 10 mg/l and 2 ng/ml respectively. We considered blood culture as gold standard.

Results: Sensitivity and specificity of PCT was 68.40% and 3.20 % respectively whereas for CRP it was 57.89% and 64.52% respectively. Positive predictive value and negative predictive value of PCT was only 30.2% and 14.30% respectively as compared to 50% and 71.43% with CRP. Median value of PCT and CRP was higher in gram negative sepsis [4.00(1.51-23.25) ng/ml] and [12.70(4.60-49.10) mg/l] respectively as compared to gram positive sepsis [2.25(1.38-3.98) and 5.60(1.70-20.30) ng/ml respectively], but it was not statistically significant. Median of PCT was higher in LONS group as compared to EONS group [15.00(7.3-6.67) vs 4.60(2.01-8.50) ng/ml], but the difference was not statistically significant (p=0.178).

Conclusions: PCT is not a better marker as compared to CRP for diagnosis of sepsis in preterm VLBW neonates.

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