Umbilical cord blood serum procalcitonin by Time-Resolved Amplified Cryptate Emission (TRACE) technology: reference values of a potential marker of vertically transmitted neonatal sepsis.
BACKGROUND
Neonatal infection remains a major diagnostic problem because of non-specific clinical signs and symptoms, as well as low sensitivity and specificity of routine laboratory tests. C-reactive protein (CRP), white blood cell count, absolute neutrophil count and immature/total neutrophil ratio are the most widely used tests in the diagnosis of sepsis and provide useful information, but none of these has demonstrated to be reliable in detecting all septic infants. Procalcitonin (PCT) has been suggested as a potentially useful laboratory test performed in umbilical cord blood when perinatal bacterial sepsis is under investigation.


METHODS
In this study, the reference interval for umbilical cord blood serum PCT was established for the first time by Time-Resolved Amplified Cryptate Emission (TRACE) technology.


RESULTS
The reference interval for PCT in umbilical cord blood serum ranged from 0.04 to 0.43 microg/L in 168 non-infected newborn infants (95% CI 0.02-0.06 and 0.35-0.60 microg/L, respectively). Cord blood serum PCT correctly classified one infected patient out of 90 newborn infants at risk of vertically transmitted sepsis and identified another neonate as a potentially infected patient despite having negative blood cultures. However, cord blood CRP misclassified 21 out of the 90 patients as infected neonates.


CONCLUSIONS
Cord blood PCT measured by TRACE is a potentially more useful early marker of neonatal sepsis than cord blood CRP.
Llorente
Elena
E
Hospital Universitario Central de Asturias, Servicio de Bioquímica, Oviedo, Spain.
Prieto
Belén
B
Cardo
Leyre
L
Avello
Noelia
N
Alvarez
Francisco V
FV
D002116:Calcitonin / Q000097:blood* / Q000592:standards; D015740:Calcitonin Gene-Related Peptide; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood* / Q000592:standards; D012016:Reference Values; D018805:Sepsis / Q000175:diagnosis* / Q000635:transmission
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide