Combined detection of procaicltonin and C-reactive protein in the early diagnosis of neonatal nosocomial infection

Abstract

Objective The early stage of neonatal sepsis is short of specific clinical manifestations that easy to be misdiagnosed.This study aimed to demonstrate the clinical value of combined markers[procaicltonin(PCT) and C-reactive protein(CRP)]in the early diagnosis of neonatal hospital-acquired infections by dynamic monitoring of PCT and CRP. Methods The study included 111 neonates in the 1st Neonatal Ward of Shengjing Hospital from June 2013 to August 2014 which were divided into three groups and retrospectively reviewed, including 37 cases of diagnosed sepsis group, 42 cases of clinical sepsis group, and 32 cases of control group(non-sepsis neonates). We measured the serum levels of PCT and CRP in two sepsis group before antibiotic administration, 12 h and 24 h after infection, 3 d and 7 d after infection controlled, and in the control group before antibiotic administration. Results Before antibiotic administration, serum levels of PCT and CRP were significantly higher in two sepsis groups than in the control group(P 2 ng/ml and CRP>10 mg/L(Youden index 76.11%, 59.45%), the sensitivity were 88.61% and 75.70% ; specificity were 87.5% and 83.75% ; positive predictive value were 94.59% and 95.65% ; negative predictive value were 75.68% and 46.15%.Receiver operating characteristic area under the curve were 0.964, 0.887. Conclusion In early stage of sepsis, both PCT and CRP increase.The optimal cut-off values are CRP>10 mg/L and PCT>2 ng/ml.CRP reaches peak at 24 h after infection, decrease to normal at 7 d after infection controlled, while PCT reaches peak at 12 h after infection, decrease to normal at 3 d after infection controlled.Combined detection of PCT and CRP can improve the sensitivity and specificity of the early diagnosis of neonatal hospital-acquired infections. Key words: Procalcitonin; C-reactive protein; Sepsis; Early diagnosis; Newborn