Procalcitonin in detecting neonatal nosocomial sepsis

Cinzia Auriti, Ersilia Fiscarelli, Maria Paola Ronchetti, Marta Argentieri, Gabriella Marrocco, Anna Quondamcarlo, Giulio Seganti, Francesco Bagnoli, Giuseppe Buonocore, Giovanni Serra, Gianfranco Bacolla, Savino Mastropasqua, Annibale Mari, Carlo Corchia, Giusi Prencipe, Fiammetta Piersigilli, Lucilla Ravà, Vincenzo Di Ciommo

Research output: Contribution to journalArticle

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. Setting: Six neonatal intensive care units (NICUs). Patients: 762 neonates admitted to six NICUs during a 28-month observational study for whom at least one serum sample was taken on admission. Main outcome measures: 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.

Original languageEnglish
JournalArchives of Disease in Childhood: Fetal and Neonatal Edition
Volume97
Issue number5
DOIs
Publication statusPublished - Sep 2012

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Calcitonin
Sepsis
Very Low Birth Weight Infant
Neonatal Intensive Care Units
Newborn Infant
Serum
Birth Weight
Observational Studies
Outcome Assessment (Health Care)
Neonatal Sepsis
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology

Cite this

Procalcitonin in detecting neonatal nosocomial sepsis. / Auriti, Cinzia; Fiscarelli, Ersilia; Ronchetti, Maria Paola; Argentieri, Marta; Marrocco, Gabriella; Quondamcarlo, Anna; Seganti, Giulio; Bagnoli, Francesco; Buonocore, Giuseppe; Serra, Giovanni; Bacolla, Gianfranco; Mastropasqua, Savino; Mari, Annibale; Corchia, Carlo; Prencipe, Giusi; Piersigilli, Fiammetta; Ravà, Lucilla; Di Ciommo, Vincenzo.

In: Archives of Disease in Childhood: Fetal and Neonatal Edition, Vol. 97, No. 5, 09.2012.

Research output: Contribution to journalArticle

Auriti, C, Fiscarelli, E, Ronchetti, MP, Argentieri, M, Marrocco, G, Quondamcarlo, A, Seganti, G, Bagnoli, F, Buonocore, G, Serra, G, Bacolla, G, Mastropasqua, S, Mari, A, Corchia, C, Prencipe, G, Piersigilli, F, Ravà, L & Di Ciommo, V 2012, 'Procalcitonin in detecting neonatal nosocomial sepsis', Archives of Disease in Childhood: Fetal and Neonatal Edition, vol. 97, no. 5. https://doi.org/10.1136/fetalneonatal-2010-194100
Auriti, Cinzia ; Fiscarelli, Ersilia ; Ronchetti, Maria Paola ; Argentieri, Marta ; Marrocco, Gabriella ; Quondamcarlo, Anna ; Seganti, Giulio ; Bagnoli, Francesco ; Buonocore, Giuseppe ; Serra, Giovanni ; Bacolla, Gianfranco ; Mastropasqua, Savino ; Mari, Annibale ; Corchia, Carlo ; Prencipe, Giusi ; Piersigilli, Fiammetta ; Ravà, Lucilla ; Di Ciommo, Vincenzo. / Procalcitonin in detecting neonatal nosocomial sepsis. In: Archives of Disease in Childhood: Fetal and Neonatal Edition. 2012 ; Vol. 97, No. 5.
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AU - Fiscarelli, Ersilia

AU - Ronchetti, Maria Paola

AU - Argentieri, Marta

AU - Marrocco, Gabriella

AU - Quondamcarlo, Anna

AU - Seganti, Giulio

AU - Bagnoli, Francesco

AU - Buonocore, Giuseppe

AU - Serra, Giovanni

AU - Bacolla, Gianfranco

AU - Mastropasqua, Savino

AU - Mari, Annibale

AU - Corchia, Carlo

AU - Prencipe, Giusi

AU - Piersigilli, Fiammetta

AU - Ravà, Lucilla

AU - Di Ciommo, Vincenzo

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N2 - 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. Setting: Six neonatal intensive care units (NICUs). Patients: 762 neonates admitted to six NICUs during a 28-month observational study for whom at least one serum sample was taken on admission. Main outcome measures: 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.

AB - 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. Setting: Six neonatal intensive care units (NICUs). Patients: 762 neonates admitted to six NICUs during a 28-month observational study for whom at least one serum sample was taken on admission. Main outcome measures: 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.

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