Abstract
Procalcitonin (PCT) levels are elevated early after birth in newborn infants; however, the physiological features and reference of serum PCT concentrations have not been fully studied in preterm infants. The aims of the current study were to establish an age-specific percentile-based reference curve of serum PCT concentrations in preterm infants and determine the features. The PCT concentration peaked in infants at 1 day old and decreased thereafter. At 1 day old, serum PCT concentrations in preterm infants <34 weeks’ gestational age were higher than those in late preterm infants between 34 and 36 weeks’ gestational age or term infants ≥37 weeks’ gestational age. Although the 50-percentile value in late preterm and term infants reached the adult normal level (0.1 ng/mL) at 5 days old, it did not in preterm infants. It took 9 weeks for preterm infants to reach it. Serum PCT concentrations at onset in late-onset infected preterm infants were over the 95-percentile value. We showed that the physiological feature in preterm infants was significantly different from that in late preterm infants, even in those <37 weeks’ gestational age. To detect late-onset bacterial infection and sepsis, an age-specific percentile-based reference curve may be useful in preterm infants.
Highlights
(NICU) for a long period are at a very high risk of health care-associated late-onset sepsis or bacterial infection[26], their long-term normal reference range of serum PCT should be established
As the serum PCT concentration in preterm infants is age-dependent, the reference for the serum PCT concentration should be used before 9 weeks of age
Neonatal sepsis or bacterial infection is a major cause of growth outcomes and neurological sequelae, especially in preterm infants[27]
Summary
(NICU) for a long period are at a very high risk of health care-associated late-onset sepsis or bacterial infection[26], their long-term normal reference range of serum PCT should be established. The aims of the present study were to 1) establish age-specific percentile-based reference curves of serum PCT in late preterm and preterm infants early after birth and determine the physiological features of PCT; 2) determine the age when infants’ serum PCT reaches ≤ 0.1 ng/mL, which is the reference range for adults and children, in preterm infants; and 3) evaluate changes in serum PCT concentrations in preterm infants who develop late-onset sepsis or bacterial infection using the 95-percentile reference curve we established
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