title: [Cord blood procalcitonin in the assessment of early-onset neonatal sepsis].
abstract: BACKGROUND
  Early diagnosis of early-onset neonatal sepsis (EONS) is essential to reduce morbidity and mortality. Procalcitonin (PCT) in cord blood could provide a diagnosis of infected patients from birth.
  
  
  OBJECTIVE
  To study the usefulness and safety of a procedure for the evaluation of newborns at risk of EONS, based on the determination of PCT in cord blood.
  
  
  METHODS
  Neonates with infectious risk factors, born in our hospital from October 2013 to January 2015 were included. They were processed according to an algorithm based on the values of cord blood procalcitonin (< 0.6ng/ml versus ≥0.6ng/ml). They were later classified as proved infection, probable, or no infection.
  
  
  CONCLUSIONS
  Of the 2,519 infants born in the study period, 136 met inclusion criteria. None of 120 cases with PCT<0.6ng/ml in cord blood developed EONS (100% negative predictive value). On the other hand, of the 16 cases with PCT ≥0.6ng/ml, 10 were proven or probably infected (62.5% positive predictive value). The sensitivity of the PCT against infection was 100%, with a specificity of 95.2% (area under the receiver operator curve 0.969). The incidence of infection in the study group was 7.4%, and 26.1% in cases with maternal chorioamnionitis. 21 newborn (15.4%) received antibiotic therapy. The studied protocol has shown to be effective and safe to differentiate between patients with increased risk of developing an EONS, in those where the diagnostic and therapeutic approach was more interventionist, versus those with less likelihood of sepsis, who would benefit from a more conservative management.
authors.affiliation: Unidad de Neonatología, Servicio de Pediatría, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España. Electronic address: olivia.oria@salud.madrid.org.
authors.forename: Olivia
authors.initials: O
authors.lastname: Oria de Rueda Salguero
authors.affiliation: Unidad de Neonatología, Servicio de Pediatría, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors.forename: José
authors.initials: J
authors.lastname: Beceiro Mosquera
authors.affiliation: Unidad de Neonatología, Servicio de Pediatría, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Barrionuevo González
authors.affiliation: Unidad de Neonatología, Servicio de Pediatría, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Ripalda Crespo
authors.affiliation: Unidad de Neonatología, Servicio de Pediatría, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Olivas López de Soria
mesh_terms: D002985:Clinical Protocols; D005312:Fetal Blood; D006801:Humans; D007231:Infant, Newborn; D000071074:Neonatal Sepsis / Q000097:blood* / Q000175:diagnosis*; D000077740:Procalcitonin / Q000097:blood*; D012189:Retrospective Studies; D018570:Risk Assessment
chemical_list: D000077740:Procalcitonin
keywords: Chorioamnionitis; Cord blood; Corioamnionitis; Diagnóstico de sepsis; Early onset neonatal sepsis; Inflamatory markers; Marcadores inflamatorios; Neonatal infection risk; Newborn; Procalcitonin; Procalcitonina; Recién nacido; Riesgo infeccioso neonatal; Sangre de cordón; Sepsis diagnosis; Sepsis neonatal precoz