Procalcitonin serum levels in perinatal bacterial and fungal infection of preterm infants.
OBJECTIVE
To determine reference values for procalcitonin (PCT) and C-reactive protein (CRP) for gestational age and to use these parameters as diagnostic markers of perinatal bacterial and fungal infection.


METHODS
PCT and CRP serum levels were measured in a case-control study in a group of 35 low birthweight infants (< 34 wk of gestation). 27 babies (77%) had clinical signs of infection confirmed by positive blood cultures and were compared to 8 (23%) uninfected matched patients. Seventeen (63%) of them had bacterial infection and 10 (37%) had fungal infection (Candida). Serum PCT (Brahms Diagnostika) and CRP (Immunoassay Vitros 950) were measured serially at 3, 7 and 10d of life.


RESULTS
At any time, PCT and CRP levels were significantly higher in neonates with perinatal infection (p < 0.05) (> 0.7 ng ml(-1) and > 1 mg dl(-1) respectively). PCT showed a more rapid response to infection (9.3 +/- 1.5 ng ml(-1)). especially to bacterial infection (10.8 +/- 1.4 ng ml(-1)), than CRP (1.5 +/- 0.5 mg dl(-1)) (sensitivity 99% vs 88%). Lower sensitivity was noted for both parameters. PCT and CRP, to follow babies with fungal infection (6.7 +/- 0.8 ng ml(-1) and 0.9 +/- 0.7 mg dl(-1), respectively) (sensitivity 77% vs 58%).


CONCLUSIONS
This study gives PCT reference values in preterm babies with perinatal infection. In these babies, PCT seems to be more sensitive than CRP as a diagnostic marker of infection. Both parameters can be used alone or in combination for a better identification and follow-up of bacterial and fungal infection during the perinatal period.
Distefano
G
G
Department of Pediatrics, University of Catania, Italy.
Curreri
R
R
Betta
P
P
Romeo
M G
MG
Amato
M
M
D001424:Bacterial Infections / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D016469:Fungemia / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011498:Protein Precursors / Q000097:blood*; D012680:Sensitivity and Specificity
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide