Procalcitonin vs. the combination of micro-erythrocyte sedimentation rate and C-reactive protein for diagnosing neonatal bacterial sepsis
Abstract: Background Given the
high rates of mortality and morbidity in neonatal sepsis, rapid, easy-to-use,
and inexpensive biomarkers with high sensitivity and specificity are needed to
diagnose neonatal sepsis. Procalcitonin is often used as a predictor in
identifying neonatal sepsis, but C-reactive protein (CRP) and micro-erythrocte
sedimentation rate (m-ESR) may also be valid biomarkers of neonatal sepsis.
Objective To compare the accuracy of procalcitonin to the combination of
CRP and m-ESR, as well as to find cut-off points for the three tests, in
diagnosing bacterial neonatal sepsis.
Methods Subjects were neonates hospitalized from July to October 2016 in
Mohammad Hoesin Hospital, Palembang with sepsis at clinical presentation and
healthy neonates with sepsis risk factors. All subjects underwent complete
blood counts, CRP, m-ESR, blood cultures, and
procalcitonin examinations.
Results Ninety-four infants were included, of whom 26 had proven sepsis.
The combined values of m-ESR and CRP had 85% sensitivity, 59% specificity, and
66% accuracy. A procalcitonin (PCT) cut-off point of 9.7ng/mL showed 100%
sensitivity, 96% specificity, and 97% accuracy level, which were significantly
higher than the combined values of m-ESR and CRP.
Conclusion The combined values of m-ESR (13 mm/hour) - CRP (17 mg/dL) and
procalcitonin alone (2ng/mL) are both valid for the diagnosis of bacterial neonatal
sepsis, but the accuracy of procalcitonin at 9.7ng/mL is significantly greater.
Keywords: neonatal sepsis;
m-ESR; CRP; procalcitonin; blood culture
Author: Afifa Ramadanti, Renya
Hiasinta, Herman Bermawi, Erial Bahar
Journal Code: jpkedokterangg170182
