Rapid quantitative procalcitonin measurement to diagnose nosocomial infections in newborns

Abstract

Background and objective: Serum procalcitonin (PCT) monitoring may help clinicians to manage nosocomial infections in neonates. This study investigated the diagnostic value of a new, rapid method to measure PCT and sought to determine the best cutoff value.

Methods: This monocentric, prospective study included all newborns with clinical suspicion of infection in a neonatal intensive care unit. Rapid, automated PCT measurements were performed on blood samples obtained for C-reactive protein (CRP) measurement. Negative and positive predictive values, sensitivity, and specificity were calculated. Logistic regression analysis determined the best cutoff value to obtain a negative predictive value of PCT that was at least 15% above that of CRP.

Results: Between June 2005 and May 2006, 73 newborns with a gestational age of 28 [26-30] weeks (median [Q25-Q75]) and a birth weight of 995 [720-1350] g were included. Thirty (41%) were infected. The best PCT cutoff value was 0.6 ng/mL, which provided a negative predictive value of 100%. The sensitivity, specificity, and positive predictive value were 100%, 65%, and 67%, respectively, for PCT at the 0.6 ng/mL cutoff value.

Conclusion: Rapid measurement of PCT could help to rule out nosocomial infection in newborns hospitalized in intensive care units.