Abstract
BackgroundAs an early recognition of neonatal sepsis is important for triggering the initiation of treatment, this study was thus designed to assess the diagnostic performance and discrimination value of procalcitonin (PCT) in neonatal sepsis cases.MethodsThis cross-sectional study, which was carried out at the Paediatric Intensive Care Unit of Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia, had involved 60 neonates admitted for suspected sepsis. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and the area under receiver operating characteristics curve (AUC) for PCT were determined at initial presentation (0 h) as well as 12 h and 24 h after presentation in comparison to blood culture as the gold standard.ResultsThe study consisted of 27 (45.0%) male and 33 (55.0%) female neonates with a mean (SD) age of 76.8 (48.25) h. At cut-off PCT value of > 2 ng/mL, the sensitivity, specificity, PPV and NPV were 66.7%, 66.7%, 33.3% and 88.9% at 0 h. The respective parameters were 83.3%. 56.3%, 32.3% and 93.1% at 12 h and 83.3%, 52.1%, 30.3% and 92.6% at 24 h. AUC was 71.6%, 76.6% and 71.7% at 0 h, 12 h and 24 h.ConclusionsDiagnostic performance and discrimination values of PCT for diagnosis of neonatal sepsis varied with time of obtaining the blood samples. The PCT result at 12 h demonstrates the most optimal diagnostic performance and discrimination values.
Highlights
Neonatal sepsis is the leading cause of neonatal morbidity and mortality, which has become an on-going major global public health challenge [1, 2]
While many developing countries are still facing a sub-standard method in the detection of neonatal sepsis, the non-specific signs and symptoms of this disease had made it even harder for most of the sophisticated hospital settings to arrive at a correct clinical diagnosis [3]
The PCT can be considered as an alternative diagnostic tool to the standard blood cultures, where the latter had long been recognised as the gold standard of neonatal sepsis diagnosis [10]
Summary
Neonatal sepsis is the leading cause of neonatal morbidity and mortality, which has become an on-going major global public health challenge [1, 2]. For this reason, an early and accurate detection of this condition is seen as essential for providing a secondary prevention of neonatal sepsis with the initiation of prompt treatments that reduce the mortality rates and devastating complications among the neonates, and for preventing the possibilities. Of all the biomarkers that had been evaluated, many authors had found the procalcitonin (PCT) to be a promising marker for the diagnosis of neonatal sepsis [6]. As an early recognition of neonatal sepsis is important for triggering the initiation of treatment, this study was designed to assess the diagnostic performance and discrimination value of procalcitonin (PCT) in neonatal sepsis cases
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