Procalcitonin in Preterm Neonates: A Different Threshold and Prolonged Interpretation.

Blandine Bianco,Marine Butin,Bérengère François-Garret,Sergio Eleni Dit Trolli,Florence Casagrande,Cyril Dalmasso,Mostafa Mokhtari

doi:10.3389/fped.2021.623043

Abstract

Objectives: To evaluate the positive threshold of PCT for neonates of <32 weeks of gestation for the diagnosis of early-onset sepsis and to determine if the level of PCT collected within 6 h of life could be used.Design: Retrospective and bicentric study from May 2016 to April 2018.Setting: Two groups were established, neonates evaluated for PCT at birth (CordPCT) and within 6 h of life (delPCT).Patients: Two hundred and sixty neonates of <32 weeks of gestation born in Nice and South Paris (Bicêtre) University Hospitals, had been evaluated for PCT level.Main Outcomes Measures: The value of the PCT positive threshold was determined for the total population and each groups thanks ROC curves.Results: The threshold level of PCT for the total population was 0.98 ng/mL. The threshold value of cordPCT group was 1.00 vs. 0.98 ng/mL for delPCT group. The area under the Receiver Operating Characteristics curve for PCT sampled in delPCT group was significantly higher than in cordPCT group (0.94 compared to 0.75).Conclusions: The threshold level of PCT was higher in this cohort of neonates of <32 weeks of gestation compared to the value generally described for term neonates. The secondary sampling PCT level seems to be usable in screening algorithm for early-onset neonatal sepsis.

Highlights

Early-onset neonatal sepsis (EOS) is defined as a systemic infection occurring within the first 72 h of life [1]
Five hundred and eleven premature neonates
Two hundred and sixty neonates were included into the statistical analysis; 173 samples for PCT were obtained at birth and 87 in the first 6 h of life

Summary

Introduction

Early-onset neonatal sepsis (EOS) is defined as a systemic infection occurring within the first 72 h of life [1]. Diagnosis is still difficult when considering the perinatal infection risk factors, such as non-specific clinical symptoms [5, 6] biomarkers of low sensitivity and blood cultures that are often negative [7]. The majority of extremely premature neonates [78.6% of neonates of

Objectives

Results

Conclusion