Clinical Value Of Procalcitonin In Neonates With Severe Bacterial Infectious Diseases

Objective Infectious diseases, especially systemic bacterial infectious diseases are still a major cause of mobility and mortality in Neonatal Intensive Care Unit (NICU). To find a marker for a prompt diagnosis making and therapeutic response monitoring is of great clinical value. PCT has now been considered as a precursory and diagnostic marker for sepsis. The aim of this research is to evaluate the diagnostic value of PCT in neonates with severe infectious disease.Methods 229 neonates were divided into 4 groups based on their history, physical examination and laboratory data: non-infected controls (116); systemic bacterial infection (39); localized bacterial infection (51) and viral infection (23). Serum PCT and CRP were measured on admission, and leucocyte count was measured within 24 hours after admission. A serial measurement of PCT and CRP were taken during the course when necessary. PCT, CRP and leucocyte count were compared in different groups using SPSS 10.0 for Windows.Results There was no difference of PCT in non-infected and non-asphyxia neonates of different gestational age, labour style, gender and age (p>0.05). PCT level increased in those with premature rupture of membranes (PROM) time≥6 hr (P<0.005) . Although both PCT and CRP significantly elevated in neonates with systemic bacterial infection compared with those in localized bacterial infection and viral infection, PCT revealed more sensitivity in systemic bacterial infection(p<0.001). In non-infected controls PCT increased in asphyxia neonates (P<0.005), but was still lower than that of neonates with systemic bacterial infection (p<0.001). While CRP level showed no difference between asphyxia and non-asphyxia neonates (p>0.05). The increment of PCT and CRP were similar in septic neonates with or without evidence of blood culture (p>0.05). The increment of PCT was earlier than that of CRP (p<0.05). The therapeutic response was related to the level of PCT. The sensitivity and specificity of PCT to diagnose Neonatal systemic bacterial infection using a cut off level 2 ng/ml was 0.824 and 0.804, respectively. Conclusion PCT was a better diagnostic maker of neonatal systemic bacterial infection than CRP and leucocyte count. And it was useful to diagnose in the early course and identify the severity of infection.