Procalcitonin measurement at 24hours of age may be helpful in the prompt diagnosis of early-onset neonatal sepsis

SummaryBackgroundThe clinical signs of early-onset neonatal sepsis (EONS) are nonspecific and indistinguishable from those of noninfectious disorders. The early diagnosis of EONS is difficult, but is essential to improve outcomes. The aim of this study was to determine the diagnostic value of procalcitonin (PCT) at birth and at 24h of age in the prompt diagnosis of EONS.MethodsThe patient group consisted of neonates with a Töllner score of ≥10 or a Töllner score of 5–10 but with the presence of prolonged rupture of the membranes (>18h) or chorioamnionitis or maternal fever (n=171). The control group (n=89) comprised neonates admitted to the neonatal intensive care unit for different disease entities. Procalcitonin levels at birth (first) and at 24h of age (second) were measured for each neonate in both of the study groups.ResultsThere was no difference between the two groups in terms of gender, birth weight, or gestational age. The mean (min–max) first PCT level was 0.48 (0.07–3.48)ng/ml in the controls and 0.51 (0.09–28.6)ng/ml in patients. The mean (min–max) second PCT level was 1.72 (0.21–18.23)ng/ml in the controls and 16.17 (0.17–100)ng/ml in patients. There was no statistically significant difference in PCT levels between the patient and control groups at birth. However, at 24h of age, PCT levels were significantly higher in the patient group than in the control group (p