Abstract
Introduction: Neonatal sepsis remains a clinical diagnostic problem. This study analyses haematological, C-reactive protein (CRP) and procalcitonin (PCT) behaviour in different clinical settings of sepsis.
Methodology: Data from neonates diagnosed with sepsis were collected and analysed. PCT determined by VIDAS® BRAHMS PCT, CRP by Immunoturbidimetry and blood counts by Flow Cytometry.
Results: Out of 21 babies, 3 had positive blood cultures and, at the time of diagnosis, PCT was extremely high (64.68, 299.9 and 382.6 ng/mL; reference range: 0.05-5.89 ng/mL) and were thrombocytopaenic. Leucocytes and neutrophiles were normal and CRP, with one exception, remained normal. Following antibiotics, PCT declined mirroring improved clinical course whilst the other parameters were generally uninformative. Ten babies with RDS and diagnosed sepsis were reviewed blindly and classified as unlikely; PCT remained either negative or increased slightly. The other parameters varied widely. Seven neonates with clinically compatible sepsis all showed raised PCT whilst the other parameters were indifferently normal or altered. One baby of 33 weeks GA deceased after severe RDS, thought to be infected, with all parameters altered, showed at post-morten severe HMD only.
Conclusion: PCT was shown to be an early marker of confirmed sepsis and follow clinical course. When PCT remained negative or slightly raised sepsis was an unlikely diagnosis. In all those cases where sepsis was a likely possibility, although not confirmed, PCT was also considerably raised. PCT, in general, was a better indicator of sepsis present or absent. However, PCT may be altered in other situation and this needs investigating.
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Almeida, C., Pinto, M., Ferreira, S. et al. 1398 Haematological, C-Reactive Protein and Procalcitonin Behaviour in Neonatal Sepsis. Pediatr Res 68 (Suppl 1), 691 (2010). https://doi.org/10.1203/00006450-201011001-01398
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DOI: https://doi.org/10.1203/00006450-201011001-01398