Document Detail


The role of procalcitonin as a predictor of nosocomial sepsis in preterm infants.
MedLine Citation:
PMID:  17129964     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To assess the role of procalcitonin in detecting nosocomial sepsis in preterm infants, after the onset of clinical symptoms. SUBJECTS: 100 preterm infants, 24-36 wk of gestation, were followed from the age of 3 d until discharge. Procalcitonin and C-reactive protein (CRP) levels were measured within 3 d of sepsis workup events. RESULTS: 141 blood samples were drawn from 36 infants during 85 episodes of sepsis workup performed between 4 and 66 d of life. Of these episodes, 51 (60%) were not a result of documented sepsis and thereby served as the negative comparison group. Median procalcitonin levels were higher in the septic group compared with the non-septic group at the time of the sepsis workup (2.7 vs 0.5 ng/ml, p=0.003), at 1-24 h after the sepsis workup (4.6 vs 0.6 ng/ml, p=0.003), and at 25-48 h (6.9 vs 2.0 ng/ml, p=0.016). Using high cutoff levels, both procalcitonin (2.3 ng/ml) and CRP (30 mg/l) had high specificity and positive predictive value (97%, 91% and 96%, 87%, respectively) but low sensitivity (48% and 41%, respectively) to detect sepsis. Areas under the ROC curve for procalcitonin and CRP were 0.74 and 0.73, respectively. CONCLUSION: Procalcitonin >2.3 ng/ml or CRP >30 mg/l indicates a high likelihood for neonatal sepsis, and antibiotic therapy should be continued even in the presence of sterile cultures.
Authors:
Dan Turner; Cathy Hammerman; Bernard Rudensky; Yechiel Schlesinger; Michael S Schimmel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  95     ISSN:  0803-5253     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-28     Completed Date:  2007-02-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  1571-6     Citation Subset:  IM    
Affiliation:
Departments of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel. dan.turner@sickkids.ca
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MeSH Terms
Descriptor/Qualifier:
Bacteria / classification,  isolation & purification,  pathogenicity
C-Reactive Protein / metabolism*
Calcitonin / blood*
Cross Infection / blood*,  diagnosis,  microbiology
Humans
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Israel
Protein Precursors / blood*
ROC Curve
Sepsis / blood*,  diagnosis,  microbiology
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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