Document Detail


Procalcitonin in the early diagnosis of nosocomial sepsis in preterm neonates.
MedLine Citation:
PMID:  17927729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To examine the diagnostic usefulness of procalcitonin (PCT), C-reactive protein and immature to total neutrophil ratio (I : T) in nosocomial sepsis among neonates treated in an intensive care unit. METHODS: A retrospective analysis and comparison of diagnostic utility performed in preterm neonates using receiver operating characteristic curves for the diagnosis of culture-proven sepsis. RESULTS: A total of 78 clinically suspected sepsis episodes in 73 newborns were analysed. The median values of PCT were: 0.56 ng/mL (interquartile range (IQR) 0.33-1.32) in group with aseptic blood culture (n = 15), 2.69 ng/mL (IQR 1.10-5.29) in Gram-positive (n = 47) and 9.36 ng/mL (IQR 3.11-39.35) in Gram-negative sepsis (n = 16). Only PCT values were significantly different (P < 0.01) among all groups. This was also true when correction for differences in blood withdrawal time was implemented. The positive and negative predictive values of PCT in the diagnosis of sepsis equalled 97.5% and 88.9%, respectively, for a cut-off value of 0.99 ng/mL. PCT was significantly better in diagnosis of sepsis than I : T (P = 0.03). No other significant differences in diagnostic efficacy were noted. The diagnostic efficacy was the highest for measurements made two or more hours since the onset of symptoms. CONCLUSIONS: The PCT serum concentration is a valuable tool for early detection of nosocomial sepsis in infants. Highest levels of PCT were observed in Gram-negative infections.
Authors:
Wojciech M Fendler; Andrzej J Piotrowski
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Publication Detail:
Type:  Journal Article     Date:  2007-10-10
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  44     ISSN:  1440-1754     ISO Abbreviation:  J Paediatr Child Health     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-29     Completed Date:  2008-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  114-8     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia and Intensive Care, Paediatric University Hospital, Medical University in Lodz, Lodz, Poland. fendler.wojciech@gmail.com
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MeSH Terms
Descriptor/Qualifier:
C-Reactive Protein / metabolism*
Calcitonin / blood*
Cross Infection / blood,  diagnosis*,  microbiology
Female
Gram-Negative Bacterial Infections / blood,  diagnosis
Gram-Positive Bacterial Infections / blood,  diagnosis
Humans
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Male
Protein Precursors / blood*
ROC Curve
Retrospective Studies
Sepsis / blood,  diagnosis*,  microbiology
Time Factors
Chemical
Reg. No./Substance:
0/Protein Precursors; 56645-65-9/procalcitonin; 9007-12-9/Calcitonin; 9007-41-4/C-Reactive Protein

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