Biochemical markers of neonatal sepsis: value of procalcitonin in the emergency setting.
BACKGROUND
We evaluated procalcitonin (PCT) assay in the emergency diagnosis of neonatal bacterial infection, especially in preterm infants, relative to C-reactive protein (CRP) and fibrinogen.


METHODS
One hundred and twenty neonates (32 preterm), of whom 21 were infected, were tested.


RESULTS
Concentrations of PCT, CRP and fibrinogen in uninfected infants were not affected by gestational age at birth. Concentrations of CRP and PCT increased rapidly during the first 24 h of life, while fibrinogen concentrations increased gradually from birth. All marker concentrations were significantly greater in neonates with bacterial infection. Receiver-operating characterstic analysis showed that optimum cut-off values for fibrinogen, CRP and PCT were 3.0 g/L, 7.5 mg/L and 2.5 microg/L respectively, for the diagnosis of sepsis at birth.


CONCLUSIONS
Determination of PCT is of value in excluding bacterial infection in neonates since it has a negative predictive value of 93%.
Guibourdenche
Jean
J
Department of Biochemistry Hôpital Robert Debré Paris, France. jean.guibourdenche@rdb.ap-hop-paris.fr
Bedu
Antoine
A
Petzold
Loïc
L
Marchand
Martine
M
Mariani-Kurdjian
Patricia
P
Hurtaud-Roux
Marie-Françoise
MF
Aujard
Yannick
Y
Porquet
Dominique
D
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005340:Fibrinogen / Q000032:analysis*; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D018805:Sepsis / Q000097:blood*
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D005340:Fibrinogen; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide