Procalcitonin measurement at 24hours of age may be helpful in the prompt diagnosis of early-onset neonatal sepsis

Abstract

In EONS, PCT measurements at birth may initially be normal; a serial PCT measurement at 24h of age may be more helpful for an early diagnosis. During the first 24h of life PCT is a more sensitive marker of infection than C-reactive protein. Further studies are needed to confirm our findings.

Predictive Value of Maternal Serum Level of Procalcitonin in Diagnosing Chorioamnionitis in Mothers with Preterm Premature Rupture of Membrane (PROM)

“…PCT is a peptide precursor of the calcitonin hormone, which is typically produced by monocytes and hepatocytes (20). The serum level of PCT rapidly increases in response to bacterial endotoxin within 3-4 hours, peaks within 18-24 hours, and remains at its elevated serum level within 24-48 hours (20).…”

Relationship between Early-Onset Neonatal Sepsis and Red Blood Cell Distribution Width (RDW)

“…The diagnosis of EONS was made according to the presence of the following parameters on clinical, laboratory, or culture screen: (1) Clinical signs consistent with infection based on the Töllner score; (2) Detection of higher CRP (≥10 mg/L) values using nephelometry method; (3) Culture-positivity detected in blood, urine and cerebrospinal fluid samples or signs of pneumonia on chest X-ray [9].…”

“…Term and near-term neonates were diagnosed with suspected clinical sepsis based on a Töllner score of ≥10 or a Töllner score of 5-10 but with the presence of one or more of the following factors associated with an increased risk of infection: maternal fever (≥38°C), prolonged rupture of membranes >18 h and clinical chorioamnionitis [9,19,20]. Inclusion criteria were positive clinical signs of sepsis and/or a history of factors associated with a raised risk of infection.…”

“…Inclusion criteria were positive clinical signs of sepsis and/or a history of factors associated with a raised risk of infection. Besides, the criteria included neonates with negative body fluid cultures who met all of the following criteria: Clinical signs of sepsis and/or radiographic findings consistent with pneumonia, a positive sepsis screen, and certain historical and clinical factors associated with a raised risk of infection [9]. Patients with established diagnosis of EONS were included in the patient group and following withdrawal of blood samples, treatment of sepsis was initiated.…”

“…Although its incidence has been currently decreased thanks to advances in obstetric and neonatal care and intrapartum prophylactic antibiotic use to prevent development of perinatal Group B streptococcal infection, it is still an important problem of the newborn [2][3][4]. Inability of the susceptibility tests performed on culture media which are accepted as gold standard for the diagnosis of EONS, to rule out neonatal sepsis because of lack of bacterial growth despite isolation of the causative bacterial agent [5,6], in addition to limited specificity, sensitivity and reliability of diagnostic markers including WBC parameters (total WBC counts, absolute number of neutrophils, immature/total neutrophil ratio) and acute phase reactants (CRP and procalcitonin) have led to the development of scoring systems which use clinical and laboratory findings in combination for the diagnosis of EONS [6][7][8][9][10].…”