Accuracy of serum procalcitonin for the diagnosis of sepsis in neonates and children with systemic inflammatory syndrome: a meta-analysis

Pontrelli, Giuseppe; Crescenzo, Franco De; Buzzetti, Roberto; Jenkner, Alessandro; Balduzzi, Sara; Carducci, Francesca Calò; Amodio, Donato; Luca, Maia De; Chiurchiù, Sara; Davies, Elin Haf; Copponi, Giorgia; Simonetti, Alessandra; Ferretti, Elena; Franco, Valeria Di; Rasi, Virginia; Corte, Martina Della; Gramatica, Luca; Ciabattini, Marco; Livadiotti, Susanna; Rossi, Paolo

doi:10.1186/s12879-017-2396-7

Cited by 95 publications

(96 citation statements)

References 45 publications

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“…Initially, the original variables were classified as risk factors / history, clinical conditions, laboratory data, and treatment modalities, as suggested in some previous reports [54]. Some newer laboratory examinations such as procalcitonin [55], various interleukins [56,57], and PCR methods [58] were not included in this study due to availability and financial reason.…”

Section: Discussionmentioning

confidence: 99%

Predictive model for bacterial late-onset neonatal sepsis in a tertiary care hospital in Thailand

et al. 2020

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Background: Early diagnosis of neonatal sepsis is essential to prevent severe complications and avoid unnecessary use of antibiotics. The mortality of neonatal sepsis is over 18%in many countries. This study aimed to develop a predictive model for the diagnosis of bacterial late-onset neonatal sepsis. Methods: A case-control study was conducted at Queen Sirikit National Institute of Child Health, Bangkok, Thailand. Data were derived from the medical records of 52 sepsis cases and 156 non-sepsis controls. Only proven bacterial neonatal sepsis cases were included in the sepsis group. The non-sepsis group consisted of neonates without any infection. Potential predictors consisted of risk factors, clinical conditions, laboratory data, and treatment modalities. The model was developed based on multiple logistic regression analysis. Results: The incidence of late proven neonatal sepsis was 1.46%. The model had 6 significant variables: poor feeding, abnormal heart rate (outside the range 100-180 x/min), abnormal temperature (outside the range 36 o -37.9°C), abnormal oxygen saturation, abnormal leucocytes (according to Manroe's criteria by age), and abnormal pH (outside the range 7.27-7.45). The area below the Receiver Operating Characteristics (ROC) curve was 95.5%. The score had a sensitivity of 88.5% and specificity of 90.4%.Conclusion: A predictive model and a scoring system were developed for proven bacterial late-onset neonatal sepsis. This simpler tool is expected to somewhat replace microbiological culture, especially in resource-limited settings.

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Section: Discussionmentioning

confidence: 99%

Predictive model for bacterial late-onset neonatal sepsis in a tertiary care hospital in Thailand

et al. 2020

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“…High fever (T >39°C) and procalcitonin >2 ng/mL usually indicate the acute systemic inflammation as described before [32,33]. According to Table 3, the high levels of CRP, procalcitonin, and TNF-α suggested that the patient was under the phase of inflammatory factor storm.…”

Section: Discussionmentioning

confidence: 99%

“…The HVHF treatment was initiated if patients had both body temperature >39°C and procalcitonin >2 ng/mL, which indicated the acute systemic inflammation as described before [32,33]. Hemofiltration was performed using PRISMA flex device and Gambro Prisma Dialysis filters (Lakewood, CO, USA) with an M60 membrane.…”

Section: Methodsmentioning

confidence: 99%

Clinical Benefits of High-Volume Hemofiltration in Critically Ill Pediatric Patients with Severe Sepsis: A Retrospective Cohort Study

et al. 2017

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Aims: The study aimed to assess the clinical benefits of high-volume hemofiltration (HVHF) in pediatric patients with severe sepsis compared with standard-volume continuous veno-venous hemofiltration (CVVH). Methods: We retrospectively analyzed the medical records of 155 pediatric patients with severe sepsis admitted to the pediatric intensive care unit of Shanghai Children's Hospital from January 2010 to June 2016. A total of 93 patients were treated with HVHF and 62 patients were treated with CVVH. Results: HVHF treatment did not significantly reduce 28-day mortality. Moreover, there was no significant difference in reducing the plasma level of inflammatory mediators and improving hemodynamic variables between HVHF and CVVH group. However, the incidence of hyperglycemia was significantly higher in HVHF group than in CVVH group. Conclusions: There is no evidence to indicate that HVHF is superior to CVVH in reducing 28-day mortality as an adjunct to the treatment of severe sepsis in pediatric patients.

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“…Emerging shreds of evidence showing serum procalcitonin (PCT) as a measurable laboratory marker in the inflammatory response to the infection is promising due to its high sensitivity compared to CRP, but its specificity is still debated [9]. Considering the diversity in population, that is different from other global counterparts where the diagnostic utility of PCT is encouraging, there is a scarcity of studies on evaluation of the role of various biochemical markers in the diagnosis of NS especially PCT in Indian neonates.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Biomarkers of Neonatal Sepsis: Pro- Calcitonin Vs C-Reactive Protein

Akram

Naseem

2019

Int J Pediatr Res

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Background: Procalcitonin in neonatal sepsis (NS) has high sensitivity compared to C-reactive protein (CRP), but its specificity is not yet clearly defined. Objectives: Evaluation of Procalcitonin as an early marker, assessing its diagnostic utility in early-onset NS was the primary and comparing the levels of Procalcitonin with CRP was secondary objective. Method: In this observational, prospective study, neonates meeting the selection criteria were included and grouped into three, according to clinical symptoms of sepsis and blood culture. Results: Blood samples from 75 babies (male = 61.0%) were analysed; 63.0% and 37.0% were of gestational age (GA) ≥ 37 and < 37 and weeks, respectively. Birthweight <2.5 kg and >2.5 Kg was noted in 52.0% and 48.0%, respectively. Meconium stained liquor (n=34), premature rupture of membranes (n=19) and prolonged labour/instrumental delivery (n=13) were major maternal risk factors.General (45.33%), respiratory (25.33%), gastrointestinal (17.33%), cardiovascular (6.66%) symptoms were common presentation; forty one (55.0%) were negative for procalcitonin and 34 (45.0%) were positive; 61 (81.0%) tested negative for CRP, only 14 (19.0%) were positive with levels >10mg/mL. Procalcitonin positivity was statistically significant (<0.05) for males, term babies and with normal birth weight favouring procalcitonin. of seven positive blood culture, coagulase positive staphylococci (n= 03), Klebsiella(n= 02), E. coli (n=01), Pseudomonas (n=01) were isolated. On correlation with blood culture, Procalcitonin showed better sensitivity and negative predictive value. Conclusion: Procalcitoninis a better early marker than CRP in early onset NS. It hasbetter positivity for male, term and normal birth weight babies.

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Accuracy of serum procalcitonin for the diagnosis of sepsis in neonates and children with systemic inflammatory syndrome: a meta-analysis

Cited by 95 publications

References 45 publications

Predictive model for bacterial late-onset neonatal sepsis in a tertiary care hospital in Thailand

Predictive model for bacterial late-onset neonatal sepsis in a tertiary care hospital in Thailand

Clinical Benefits of High-Volume Hemofiltration in Critically Ill Pediatric Patients with Severe Sepsis: A Retrospective Cohort Study

Comparison of Biomarkers of Neonatal Sepsis: Pro- Calcitonin Vs C-Reactive Protein

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