Pradeep Kumar Gupta
Norvic International Hospital, Nepal
Title: Role of serum procalcitonin as a marker of neonatal sepsis
Biography
Biography: Pradeep Kumar Gupta
Abstract
Background: Despite the advances in perinatal and neonatal care and use of newer potent antibiotics, the incidence of neonatal sepsis remains high and the outcome is still severe. Objective: To study the role of serum procalcitonin as a marker of neonatal sepsis and to compare procalcitonin with CRP as a diagnostic marker for neonatal sepsis. Methodology: Hospital based prospective observational study. 50 neonates (preterm and term) with clinically suspected sepsis were studied during 1 year from January 2016 to December 2016 in Chaitanya Hospital, Chandigarh. Conventional sepsis workup was done in all cases and the diagnosis of neonatal sepsis was proved based on the results of blood culture. The serum procalcitonin was measured by quantitative Enzyme Linked Immunofluorescence Assay (ELISA) and the results were compared to CRP levels between the neonates with or without proven sepsis. Results: Of the total 220 babies admitted in NICU during that period, 50 were eligible for study and analyzed. 24% babies had definite sepsis, 60% had probable sepsis and 16% babies had no sepsis. Of the neonates with suspected sepsis, 24% had culture positive and 76% were culture negative. Mean PCT level was 13.27±33.2 ng/ml. The mean PCT levels was highest in neonates whose TLC>5000 (Mean PCT-18.5) (p value-0.002). Evaluating CRP as a diagnostic marker for definite neonatal sepsis with cut off value as 0.5 mg/dl, had sensitivity of 41.67%, specificity of 89.47%, positive predictive value of 55.56% and negative predictive value of 82.93%. Evaluating PCT as a diagnostic marker for definite neonatal sepsis, the sensitivity, specificity, positive predictive value, negative predictive value were 83.3%, 26.32%, 26.32% and 83.3% respectively taking cut-off level of procalcitonin to be >0.5 ng/ml. Conclusion: The importance of procalcitonin in diagnosing neonatal septicemia cannot be denied but it becomes more useful when it is used along with other investigations for decision making.