Procalcitonin as a Screening Test for Late-Onset Sepsis in Preterm Very Low Birth Weight Infants

Vazzalwar, Ramesh; Pina-Rodrigues, Estela; Puppala, Bhagya L.; Angst, Denise B.; Schweig, Lorene

doi:10.1038/sj.jp.7211296

Cited by 65 publications

(18 citation statements)

References 24 publications

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“…It is noteworthy to consider that studies on EOS with a PCT cut-off <2 ng/ml were all grouped together with LOS, and the two studies focusing on LOS only [42, 47] found that the PCT at this cut-off had a better accuracy, higher specificity and similar sensitivity, if compared with studies grouping EOS and LOS. This suggests that the use of two different cut-offs could improve accuracy in these two populations: PCT cut-off could be higher for neonates with EOS than for neonates with LOS.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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BackgroundA number of biomarkers have been studied for the diagnosis of sepsis in paediatrics, but no gold standard has been identified. Procalcitonin (PCT) was demonstrated to be an accurate biomarker for the diagnosis of sepsis in adults and showed to be promising in paediatrics. Our study reviewed the diagnostic accuracy of PCT as an early biomarker of sepsis in neonates and children with suspected sepsis.MethodsA comprehensive literature search was carried out in Medline/Pubmed, Embase, ISI Web of Science, CINAHL and Cochrane Library, for studies assessing PCT accuracy in the diagnosis of sepsis in children and neonates with suspected sepsis. Studies in which the presence of infection had been confirmed microbiologically or classified as “probable” by chart review were included. Studies comparing patients to healthy subjects were excluded. We analysed data on neonates and children separately.Our primary outcome was the diagnostic accuracy of PCT at the cut-off of 2-2.5 ng/ml, while as secondary outcomes we analysed PCT cut-offs <2 ng/ml and >2.5 ng/ml. Pooled sensitivities and specificities were calculated by a bivariate meta-analysis and heterogeneity was graphically evaluated.ResultsWe included 17 studies, with a total of 1408 patients (1086 neonates and 322 children). Studies on neonates with early onset sepsis (EOS) and late onset sepsis (LOS) were grouped together. In the neonatal group, we calculated a sensitivity of 0.85, confidence interval (CI) (0.76; 0.90) and specificity of 0.54, CI (0.38; 0.70) at the PCT cut-off of 2.0-2.5 ng/ml. In the paediatric group it was not possible to undertake a pooled analysis at the PCT cut-off of 2.0-2.5 ng/ml, due to the paucity of the studies.ConclusionsPCT shows a moderate accuracy for the diagnosis of sepsis in neonates with suspected sepsis at the cut-off of 2.0-2.5 ng/ml. More studies with high methodological quality are warranted, particularly in neonates, studies considering EOS and LOS separately are needed to improve specificity.Trial registrationPROSPERO Identifier: CRD42016033809. Registered 30 Jan 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2396-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…In this regard, some reports claim PCT to be more sensitive than CRP [7], but others have shown that PCT lacks specificity [8] and does not have any advantage over CRP [9,10]. Serum PCT cut-off of 1.0 ng/ml and CRP cut-off of 0.8 mg/dl were comparable in identification of blood-culturepositive sepsis [11]. CRP has been shown to be useful for accurately differentiating septic and nonseptic events in neonates [12].…”

Section: Discussionmentioning

confidence: 99%

Values of C‐reactive protein, procalcitonin, and Staphylococcus‐specific PCR in neonatal late‐onset sepsis

et al. 2006

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“…In addition, PCT is increased (to the same levels as sepsis) after chorioamnionitis, even if the child is healthy (57). Despite these cases of false positives, PCT remains, in many cases superior to C-reactive protein (CRP) in predicting sepsis (59).…”

Section: Future Diagnostic Toolsmentioning

confidence: 99%

The developing immune system – from foetus to toddler

2011

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Procalcitonin as a Screening Test for Late-Onset Sepsis in Preterm Very Low Birth Weight Infants

Abstract: PCT (0.5 ng/ml) is more sensitive than CRP in predicting late-onset sepsis in VLBW infants.

Cited by 65 publications

References 24 publications

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

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

Values of C‐reactive protein, procalcitonin, and Staphylococcus‐specific PCR in neonatal late‐onset sepsis

The developing immune system – from foetus to toddler

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