Procalcitonin in Early Diagnosis of Neonatal Sepsis: A Cross-Sectional Study

Abstract

Neonatal sepsis still remains a major cause of mortality and morbidity in newborns, specially in developing countries. Early diagnosis is very important but sometimes challenging due to non-specific clinical signs. This study was conducted to assess the role of Procalcitonin (PCT) as an early diagnostic marker in neonatal sepsis.

A hospital based cross-sectional study was conducted on 80 neonates admitted in NICU with suspected sepsis. Blood samples were collected within first 24 hours of admission and PCT levels were measured using immunoassay method. Routine sepsis screen including CRP, total leukocyte count (TLC), ANC and blood culture were also done.

Out of 80 neonates, 45 were culture positive and 35 were culture negative. PCT levels were significantly higher in culture positive group (mean PCT = 4.1 ng/ml) compared to culture negative group (mean = 0.86 ng/ml), p<0.01. Sensitivity and specificity of PCT at cutoff >2 ng/ml was 84.4% and 78.2% respectively. Compared to CRP, PCT showed better sensitivity and early rise.

The findings shows that Procalcitonin is a useful early biomarker for diagnosing neonatal sepsis and can help to start antibiotics early. Since culture results takes time and are not always positive, using PCT as part of sepsis screen may help improve outcomes. However, cost and availability of PCT testing can be a limiting factor in some settings. Further studies with larger samples and different gestational age groups are recommended to support findings.