Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Apr;181(4):1459-1464.
doi: 10.1007/s00431-021-04326-2. Epub 2021 Nov 30.

Procalcitonin is a prognosis biomarker in very preterm neonates with late onset sepsis: a pilot study

Valerie Ruetsch  1 , Simon Barreault  1   2 , Nolwenn Le Sache  1 , Pierre Tissères  3   4   5
Affiliations
Observational Study

Procalcitonin is a prognosis biomarker in very preterm neonates with late onset sepsis: a pilot study

Valerie Ruetsch et al. Eur J Pediatr. 2022 Apr.

Abstract

Neonatal sepsis contributes substantially to neonatal morbidity and mortality. Procalcitonin (PCT) is a recognized biomarker for the diagnosis of late-onset neonatal sepsis (LONS); however, little is known about the prognosis value of PCT in LONS. This study aims at assessing PCT value as a prognosis biomarker in preterm infants with LONS. Retrospective single center observational cohort study. All premature infants (less than 32 weeks of gestational age) with LONS admitted in a tertiary neonatal intensive care unit. Among the 59 preterm infants included in the analysis, 48 survived (81.4%, 48/59). Deceased patients had a significantly lower postmenstrual age (30 [29-32] vs. 28 [27-30], p = 0.025) and weight (1072 [850-1320] vs. 820 [730-1065], p = 0.016) at the time of LONS diagnosis. Although PCT values were not different between both groups at the time of LONS diagnosis, it was more elevated during the first 24 h in deceased patients (12 [1.1-20.3] vs. 1.57 [0.6-4.1], p = 0.041). Accuracy of PCT for predicting 60-day mortality in preterm neonates with LONS ranged from 0.70 to 0.82 of area under the curve on receiver operating characteristic curves. Optimal PCT cut-off values at LONS diagnosis was 8.92 µg/L, 15.75 µg/L for PCT values during the first 24 h, and 6.74 µg/L between 24 and 48 h after diagnosis. The estimated survival probability at day 60 was above 95% for patient with a PCT value at sepsis diagnosis under 8.92 µg/L and less than 45% if higher (p < 0.0001).

Conclusion: A PCT value > 8.92 µg/L obtained at LONS diagnosis suspicion seems to be a good prognosis biomarker.

What is known: •Procalcitonin (PCT) is a recognized biomarker of 28-day mortality in critically ill adults with septic shock and trauma. •Failure to have decreased in PCT in the first days of critical care is associated with increased mortality.

What is new: •Hereby, we show that PCT has a prognosis value in premature infants with late-onset neonatal sepsis. •Procalcitonin value > 8.92 µg/L at LONS diagnosis is associated with an increase at 60-day mortality.

Keywords: LONS; Mortality; Neonatal sepsis; PCT; Prognosis.

PubMed Disclaimer

Comment in

References

    1. Dong Y, Speer CP (2015) Late-onset neonatal sepsis: recent developments. Arch Dis Child Fetal Neonatal Ed 100(3):F257–F263 - DOI - PubMed
    1. Gowda H, Norton R, White A, Kandasamy Y (2017) Late-onset neonatal sepsis-a 10-year Review from North Queensland. Australia Pediatr Infect Dis J 36(9):883–888 - DOI - PubMed
    1. Greenberg RG, Kandefer S, Do BT et al (2017) Late-onset sepsis in extremely premature infants: 2000–2011. Pediatr Infect Dis J 36(8):774–779 - DOI - PubMed - PMC
    1. Stoll BJ, Hansen NI, Bell EF et al (2010) Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics 126(3):443–456. https://doi.org/10.1542/peds.2009-2959 - DOI - PubMed
    1. Perlman, Sharon E et al (2007) Risk factors for late-onset health care-associated bloodstream infections in patients in neonatal intensive care units. Am j infection control 35(3):177–82. https://doi.org/10.1016/j.ajic.2006.01.002

Publication types

LinkOut - more resources