Serum procalcitonin: Early detection of neonatal bacteremia and septicemia in a tertiary healthcare facility

BACKGROUND: The benefits of procalcitonin measurement in neonatal bacteremia/septicemia with suspected nosocomial infection are unclear and unresearched. AIM: The aim of the study was to assess procalcitonin value as an early or first line diagnosis/prognosis for bacterial neonatal septicemic infection in selected critically ill neonates. PATIENTS AND METHODS: An observational cohort study in a 10-bed intensive care unit was performed. Sixty neonates, with either proven or clinically suspected, but not confirmed, bacterial neonatal septicemic infection were included. Procalcitonin measurements were obtained on the day when the infection was suspected. Neonates with proven septicemic infection were compared to those without. The diagnostic value of procalcitonin was determined through the area under the corresponding receiver operating characteristic curve (AUROCC). In addition, the predictive value of procalcitonin variations preceding the clinical suspicion of infection was also assessed. RESULTS: Procalcitonin was the best early predictor of proven infection in this population of neonates with a clinical suspicion of septicemia (AUROCC = 0.80; 91.6% CI, 0.68–0.91). In contrast, CRP elevation, leukocyte count and fever had a poor predictive value in our population. CONCLUSION: PCT monitoring could be helpful in the early diagnosis of neonatal septicemic infection in the intensive care unit. Both absolute values and variations should be considered and evaluated in further studies.