Rapid quantitative procalcitonin measurement to diagnose nosocomial infections in newborn infants.
OBJECTIVE
Serum procalcitonin (PCT) monitoring may help clinicians to manage nosocomial infections in neonates. This study investigated the diagnostic value of a new, rapid method to measure PCT and sought to determine the best cut-off value.


METHODS
This monocentric, prospective study included all newborn infants with clinical suspicion of infection in a neonatal intensive care unit. Rapid, automated PCT measurements were performed on blood samples obtained for C-reactive protein (CRP) measurement. Negative and positive predictive values, sensitivity and specificity were calculated. Logistic regression analysis determined the best cut-off value to obtain a negative predictive value of PCT that was at least 15% above that of CRP.


RESULTS
Between June 2005 and May 2006, 73 newborn infants with a median (Q25-Q75) gestational age of 28 (26-30) weeks and a birth weight of 995 (720-1350) g were included. Thirty (41%) were infected. The best PCT cut-off value was 0.6 ng/ml, which provided a negative predictive value of 100%. The sensitivity, specificity and positive predictive value were 100%, 65%, and 67%, respectively, for PCT at the 0.6 ng/ml cut-off value.


CONCLUSIONS
Rapid measurement of PCT could help to rule out nosocomial infection in newborn infants hospitalised in intensive care units.
Jacquot
A
A
CHU de Montpellier, Service de Réanimation Néonatale, Hôpital Arnaud de Villeneuve, Montpellier, France. a-jacquot@chu-montpellier.fr
Labaune
J-M
JM
Baum
T-P
TP
Putet
G
G
Picaud
J-C
JC
D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D003428:Cross Infection / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide