Diagnosis Value Of Procalcitonin In Neonatal Early-onset Sepsis

Objective To study the value of procalcitonin(PCT)within 3 days after birth in the diagnosis of neonatal early-onset sepsis(EOS),as well as the thresholds of PCT in the diagnosis of EOS at different gestational ages and different ages in hours.Methods A total of 109 neonates with a confirmed diagnosis of sepsis,229 neonates with clinically diagnosed sepsis,and 367 neonates without sepsis were enrolled.Receiver operating characteristic(ROC)curves were plotted to determine the optimal cut-off PCT in the diagnosis of EOS in neonates with different gestational ages and different ages in hours,and the diagnostic value of PCT and blood culture was compared.Results In the confirmed diagnosis group,the neonates with a gestational age of <34 weeks had a significantly higher level of PCT than those with a gestational age of ?34 weeks(P<0.05).For the neonates with a gestational age of ?34 weeks,the optimal cut-off values of PCT in the diagnosis of EOS were 1.588 ng/mL(sensitivity 0.688,specificity 0.851)at 0-<12 hours,4.960 ng/mL(sensitivity 0.737,specificity 0.883)at 12-<24 hours,5.583 ng/mL(sensitivity 0.727,specificity 0.865)at 24-<36 hours,1.710 ng/mL(sensitivity 0.810,specificity 0.755)at 36-<48 hours,3.570 ng/mL(sensitivity 0.447,specificity 0.930)at 48-<60 hours,and 3.574 ng/mL(sensitivity 0.290,specificity 0.900)at 60-72 hours.PCT had a significantly larger area under the ROC curve than blood culture within 36 hours after birth(P<0.05).Conclusions The same criteria can be used for late preterm infants and full-term infants(with a gestational age of ?34 weeks),while early preterm infants(with a gestational age of <34 weeks)should be considered separately.PCT has different optimal cutoff values in the diagnosis of EOS in neonates with different ages in hours,with a higher value than blood culture in the diagnosis of EOS within 36 hours after birth.