title: Procalcitonin in detecting neonatal nosocomial sepsis.
abstract: OBJECTIVE
  To investigate the accuracy of procalcitonin (PCT) as a diagnostic marker of nosocomial sepsis (NS) and define the most accurate cut-off to distinguish infected from uninfected neonates.
  
  
  METHODS
  Six neonatal intensive care units (NICUs).
  
  
  METHODS
  762 neonates admitted to six NICUs during a 28-month observational study for whom at least one serum sample was taken on admission.
  
  
  METHODS
  Positive and negative predictive values at different PCT cut-off levels.
  
  
  RESULTS
  The overall probability of an NS was doubled or more if PCT was >0.5 ng/ml. In very-low-birth-weight (VLBW) infants, a cut-off of >2.4 ng/ml gave a positive predictive value of NS near to 50% with a probability of a false-positive diagnosis of NS in about 10% of the patients.
  
  
  CONCLUSIONS
  In VLBW neonates, a serum PCT value >2.4 ng/ml prompts early empirical antibiotic therapy, while in normal-birth-weight infants, a PCT value ≤2.4 ng/ml carries a low risk of missing an NS.
authors.affiliation: Neonatal Intensive Care Unit, Bambino Gesù Children's Hospital, Piazza S Onofrio, 4-00165 Rome, Italy. c.auriti@agtgroup.it
authors.forename: Cinzia
authors.initials: C
authors.lastname: Auriti
authors.forename: Ersilia
authors.initials: E
authors.lastname: Fiscarelli
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Ronchetti
authors.forename: Marta
authors.initials: M
authors.lastname: Argentieri
authors.forename: Gabriella
authors.initials: G
authors.lastname: Marrocco
authors.forename: Anna
authors.initials: A
authors.lastname: Quondamcarlo
authors.forename: Giulio
authors.initials: G
authors.lastname: Seganti
authors.forename: Francesco
authors.initials: F
authors.lastname: Bagnoli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Buonocore
authors.forename: Giovanni
authors.initials: G
authors.lastname: Serra
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Bacolla
authors.forename: Savino
authors.initials: S
authors.lastname: Mastropasqua
authors.forename: Annibale
authors.initials: A
authors.lastname: Mari
authors.forename: Carlo
authors.initials: C
authors.lastname: Corchia
authors.forename: Giusi
authors.initials: G
authors.lastname: Prencipe
authors.forename: Fiammetta
authors.initials: F
authors.lastname: Piersigilli
authors.forename: Lucilla
authors.initials: L
authors.lastname: Ravà
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Ciommo
mesh_terms: D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D003428:Cross Infection / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D016013:Likelihood Functions; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis*
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide