title: Usefulness of estimation of blood procalcitonin concentration versus C-reactive protein concentration and white blood cell count for therapeutic monitoring of sepsis in neonates.
abstract: OBJECTIVE
  This study was intended to assess the clinical usefulness of blood procalcitonin (PCT) concentrations for the diagnosis and therapeutic monitoring of nosocomial neonatal sepsis.
  
  
  METHODS
  The enrolment criterion was sepsis clinically manifesting after three days of life. PCT concentrations were measured in venous blood from 52 infected and 88 uninfected neonates. The results were interpreted against C-reactive protein (CRP) concentrations and white blood cell counts (WBC).
  
  
  RESULTS
  Differences between the two groups in PCT and CRP concentrations were highly significant. No significant differences between the groups were noted for WBC. The threshold value on the receiver operator characteristic curve was 2.06 ng/mL for PCT (SE 75%; SP 80.68%; PPV 62.22%; NPV 88.75%; AUC 0.805), 5.0 mg/L for CRP (SE 67.44%; SP 73.68%; PPV 42.02%; NPV 88.89%; AUC 0.801), and 11.9 x109/L for WBC (SE 51.16%; SP 50.68%; PPV 23.16%; NPV 78.13%; AUC 0.484). Procalcitonin concentrations decreased 24 hours after initiation of antibiotic therapy and reverted to the control level after 5-7 days. C-reactive protein concentrations began to decline after two days of antibiotic therapy but were still higher than in the control group after 5-7 days of treatment. No significant changes in WBC during the treatment were observed.
  
  
  CONCLUSIONS
  Procalcitonin concentrations in blood appear to be of use for the diagnosis and therapeutic monitoring of nosocomial infections in neonates as this parameter demonstrates greater sensitivity and specificity than C-reactive protein. White blood cell counts appear to be of little diagnostic value in the early phase of infection or for therapeutic monitoring.
authors.affiliation: Klinika Patologii Noworodka Pomorskiego Uniwersytetu Medycznego w Szczecinie.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kordek
authors.affiliation: Klinika Patologii Noworodka Pomorskiego Uniwersytetu Medycznego w Szczecinie.
authors.forename: Beata
authors.initials: B
authors.lastname: Łoniewska
authors.affiliation: Katedra i Zakład Fizyki Medycznej Pomorskiego Uniwersytetu Medycznego w Szczecinie.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Podraza
authors.affiliation: Oddział Anestezjologii, Reanimacji i Intensywnej Terapii z Pododdziałem Ostrych Zatruć Samodzielnego Publicznego Szpitala Klinicznego Nr 2 w Szczecinie.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Nikodemski
authors.affiliation: Klinika Patologii Noworodka Pomorskiego Uniwersytetu Medycznego w Szczecinie.
authors.forename: Jacek
authors.initials: J
authors.lastname: Rudnicki
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D003428:Cross Infection / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007958:Leukocyte Count / Q000379:methods*; D008991:Monitoring, Physiologic / Q000379:methods; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide