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.
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.
Authors: James L Wynn; Hector R Wong; Thomas P Shanley; Matthew J Bizzarro; Lisa Saiman; Richard A Polin Journal: Pediatr Crit Care Med Date: 2014-07 Impact factor: 3.624
Authors: Luregn J Schlapbach; Rolf Graf; Andreas Woerner; Matteo Fontana; Urs Zimmermann-Baer; David Glauser; Eric Giannoni; Thierry Roger; Christoph Müller; Mathias Nelle; Martin Stocker Journal: Intensive Care Med Date: 2013-01-08 Impact factor: 17.440
Authors: Irja Lutsar; Ursula M T Trafojer; Paul T Heath; Tuuli Metsvaht; Joseph Standing; Susanna Esposito; Vincent Meiffredy de Cabre; Clarissa Oeser; Jean-Pierre Aboulker Journal: Trials Date: 2011-09-30 Impact factor: 2.279