Umbilical Cord Procalcitonin to Detect Early-Onset Sepsis in Newborns: A Promising Biomarker

Dongen, O. R. E.; Leeuwen, Lisanne M. van; Groot, P. K. de; Vollebregt, Karlijn C.; Schiering, Irene A. M.; Wevers, Brigitte A.; Euser, Sjoerd M.; Houten, Marianne A. van

doi:10.3389/fped.2021.779663

Cited by 8 publications

(8 citation statements)

References 29 publications

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“…In the present study, PCT levels in the infected group were statistically higher (1.5±0.9 ng/dl) than in the uninfected group (1.1±0.8 ng/dl) p=0.042. This was in accordance with another study (15). Furthermore, others found that PCT concentrations > 0.5 g/L were linked to a greater incidence of EOS (OR 2.18; CI95% 1.58-3.02; p < 0.0001) (16).…”

Section: Discussionsupporting

confidence: 91%

Progranulin versus procalcitonin in diagnosis of early onset neonatal sepsis

Almonaem

Elfiky

Ameen

et al. 2023

Benha Medical Journal

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Background: Neonatal sepsis is the third most common reason for neonatal mortality, which is a serious health issue. Early diagnosis can help these neonates have better outcomes. Objective: Progranulin (PGRN) and procalcitonin (PCT) were evaluated for their diagnostic utility in early-onset sepsis (EOS). Methods: The neonates in this study were born at ≥ 34 weeks gestation and hospitalized to the Neonatal Intensive Care Unit within the first 72 hours of life. The infected group contained 50 infants, whereas the uninfected group included 60 neonates. All infants had thorough clinical evaluations and lab testing. The levels of procalcitonin and progranulin in the serum were determined using ELISA. Results: At the three-time intervals, there was no noticeable difference between the groups in terms of CRP. With a p-value of 0.003, PCT was statistically more significant in the infected group (0.990.50 ng/dl) than in the uninfected group (0.40.44 ng/dl) during the 1-24 h interval, but there was no difference at the 24-48 h or 49-72 h intervals. At each of the threetime intervals when the infected and uninfected groups were compared, PGRN was considerably higher in the infected group (p 0.001). Furthermore, PGRN was statistically greater during 49-72 h intervals in the infected group compared to 1-24 h and 25-48 breaks (p=0.004). However, at various intervals, the PGRN levels in the uninfected group did not vary significantly (p=0.053). Conclusion: PGRN was found in newborn sepsis with an early onset and may be helpful as a biomarker for diagnosis.

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Section: Discussionsupporting

confidence: 91%

Progranulin versus procalcitonin in diagnosis of early onset neonatal sepsis

Almonaem

Elfiky

Ameen

et al. 2023

Benha Medical Journal

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“…A monocenter retrospective study of 2151 newborns con rmed the ability of cord blood PCT to detect early neonatal infection (cut-off value, 0.6 ng/ml; AUC, 0.96; sensitivity, 0.92; speci city, 0.97) [19]. Besides, in a prospective, single-center, case-control study, a cord blood PCT cut-off value of 0.1 ng/ml in newborns ≥ 32 weeks corresponded with an AUC of 0.8, sensitivity of 0.83 and speci city of 0.62 [20]. Furthermore, Lautridou et al [21] found that elevated umbilical cord PCT was an independent risk factor for mortality in preterm infants with GA < 33 weeks.…”

Section: Discussionmentioning

confidence: 80%

Role of umbilical cord blood procalcitonin in the noninvasive diagnosis of fetal inflammatory response syndrome: a pilot study

Cui

Shi

Sun

et al. 2022

Preprint

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Purpose: To evaluate the diagnostic effect of umbilical cord blood procalcitonin (PCT) on fetal inflammatory response syndrome (FIRS). Methods: This prospective study assessed preterm infants (100 with FIRS and 124 controls) with gestational age <32 weeks. The groups were compared in terms of the incidence of complications associated with preterm birth. To identify whether FIRS was an independent risk factor for complications of preterm birth, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multivariable logistic regression models. Finally, we clarified the diagnostic efficiency by receiver operating characteristic curves. Results: Univariate analysis showed that the incidence of natural delivery, premature rupture of membranes (PROM) > 18h, antenatal antibiotic usage, chorioamnionitis, umbilical cord blood PCT, gestational age (GA), small for gestational age (SGA), bronchopulmonary dysplasia (BPD), early-onset sepsis (EOS), necrotizing enterocolitis (NEC), white matter injury (WMI), retinopathy of prematurity (ROP), and mortality were higher in the case group than the control group (p < 0.05). Multivariable analysis confirmed a significant association between FIRS and complications of preterm birth. The level of umbilical cord blood PCT of preterm infants could be used as a noninvasive diagnostic index for FIRS (cut-off value: 0.276 ng/ml). Conclusions: Umbilical cord blood PCT may be a reliable noninvasive diagnostic biomarker for FIRS. Chorioamnionitis, natural delivery, and the level of umbilical cord blood PCT are independent risk factors for FIRS in preterm infants, while GA was a protective factor for FIRS. FIRS is an independent risk factor for BPD, EOS, NEC, WMI and ROP.

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“…reported a low umbilical cord blood procalcitonin in the healthy controls and newborn infants who were not eligible for antibiotic therapy corresponding with their non-infectious state. 27 In contrast, the sensitivity and the positive predictive value seem to be less powerful, which does not allow its use as a positive diagnostic tool. 15 Two biomarkers of inflammation appear to be of interest for the diagnosis of EOS: interleukin-6 (IL-6)…”

Section: Discussionmentioning

confidence: 99%

Early procalcitonin assays may reduce antibiotic exposure in premature newborn infants

Hue‐Bigé,

François‐Garret,

Casagrande

et al. 2024

Acta Paediatrica

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AimThe diagnosis of early‐onset neonatal sepsis (EOS) remains difficult. The main aim was to study the effect of a new algorithm for EOS, which includes the level of procalcitonin in umbilical cord blood, on the exposure to antibiotic therapy of premature newborn infants.MethodsThis was a monocentric, observational and retrospective study with before‐and‐after design. The duration and dose of antibiotic therapy provided as well as the morbidity and mortality were compared in two groups, one included 01 May 2015–30 November 2015 when procalcitonin was not used, and one after the change 01 November 2016–30 May 2017 when procalcitonin was used in a hospital setting in Nice, France.ResultsSixty newborn infants were included in the before group and 54 in the after group. Antibiotic therapy was stopped after 24 h for 18 newborn infants in the after group and four in the before group, and after 48 h for 26 newborn infants in the after group and 10 in the before group.ConclusionThe implementation of a new decision‐making algorithm including early procalcitonin assay of premature newborn infants significantly reduced exposure to antibiotics without modifying mortality or morbidity.

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Umbilical Cord Procalcitonin to Detect Early-Onset Sepsis in Newborns: A Promising Biomarker

Cited by 8 publications

References 29 publications

Progranulin versus procalcitonin in diagnosis of early onset neonatal sepsis

Progranulin versus procalcitonin in diagnosis of early onset neonatal sepsis

Role of umbilical cord blood procalcitonin in the noninvasive diagnosis of fetal inflammatory response syndrome: a pilot study

Early procalcitonin assays may reduce antibiotic exposure in premature newborn infants

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