Procalcitonin in Preterm Neonates: A Different Threshold and Prolonged Interpretation

Overview

Journal Front Pediatr

Specialty Pediatrics

Date 2021 Jun 3

PMID 34079778

Citations 1

Authors

Blandine Bianco

Berengere Francois-Garret

Marine Butin

Cyril Dalmasso

Florence Casagrande

Mostafa Mokhtari

Sergio Eleni Dit Trolli

Affiliations

Soon will be listed here.

Abstract

To evaluate the positive threshold of PCT for neonates of <32 weeks of gestation for the diagnosis of early-onset sepsis and to determine if the level of PCT collected within 6 h of life could be used. Retrospective and bicentric study from May 2016 to April 2018. Two groups were established, neonates evaluated for PCT at birth (CordPCT) and within 6 h of life (delPCT). Two hundred and sixty neonates of <32 weeks of gestation born in Nice and South Paris (Bicêtre) University Hospitals, had been evaluated for PCT level. The value of the PCT positive threshold was determined for the total population and each groups thanks ROC curves. The threshold level of PCT for the total population was 0.98 ng/mL. The threshold value of cordPCT group was 1.00 vs. 0.98 ng/mL for delPCT group. The area under the Receiver Operating Characteristics curve for PCT sampled in delPCT group was significantly higher than in cordPCT group (0.94 compared to 0.75). The threshold level of PCT was higher in this cohort of neonates of <32 weeks of gestation compared to the value generally described for term neonates. The secondary sampling PCT level seems to be usable in screening algorithm for early-onset neonatal sepsis.

Citing Articles

The diagnostic accuracy of umbilical cord procalcitonin in predicting early-onset neonatal infection.

Nguyen T, Thi D, Truong Q, Pham T PLoS One. 2025; 20(1):e0316987.

PMID: 39821188 PMC: 11737792. DOI: 10.1371/journal.pone.0316987.

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

Dongen O, van Leeuwen L, de Groot P, Vollebregt K, Schiering I, Wevers B Front Pediatr. 2021; 9:779663.

PMID: 34956986 PMC: 8704118. DOI: 10.3389/fped.2021.779663.

References

Fukuzumi N, Osawa K, Sato I, Iwatani S, Ishino R, Hayashi N . Age-specific percentile-based reference curve of serum procalcitonin concentrations in Japanese preterm infants. Sci Rep. 2016; 6:23871. PMC: 4817150. DOI: 10.1038/srep23871. View

Cottineau M, Launay E, Branger B, Caillon J, Muller J, Boscher C . [Diagnostic value of suspicion criteria for early-onset neonatal bacterial infection: report ten years after the Anaes recommendations]. Arch Pediatr. 2014; 21(2):187-93. DOI: 10.1016/j.arcped.2013.11.011. View

Monneret G, Labaune J, Isaac C, Bienvenu F, Putet G, Bienvenu J . Increased serum procalcitonin levels are not specific to sepsis in neonates. Clin Infect Dis. 1998; 27(6):1559-61. DOI: 10.1086/517758. View

Chiesa C, Pellegrini G, Panero A, Osborn J, Signore F, Assumma M . C-reactive protein, interleukin-6, and procalcitonin in the immediate postnatal period: influence of illness severity, risk status, antenatal and perinatal complications, and infection. Clin Chem. 2003; 49(1):60-8. DOI: 10.1373/49.1.60. View

Zhu D, Xiao S, Yu J, Ai Q, He Y, Cheng C . Effects of One-Week Empirical Antibiotic Therapy on the Early Development of Gut Microbiota and Metabolites in Preterm Infants. Sci Rep. 2017; 7(1):8025. PMC: 5556106. DOI: 10.1038/s41598-017-08530-9. View

Stocker M, Fontana M, El Helou S, Wegscheider K, Berger T . Use of procalcitonin-guided decision-making to shorten antibiotic therapy in suspected neonatal early-onset sepsis: prospective randomized intervention trial. Neonatology. 2009; 97(2):165-74. DOI: 10.1159/000241296. View

Shane A, Sanchez P, Stoll B . Neonatal sepsis. Lancet. 2017; 390(10104):1770-1780. DOI: 10.1016/S0140-6736(17)31002-4. View

Turner D, Hammerman C, Rudensky B, Schlesinger Y, Goia C, Schimmel M . Procalcitonin in preterm infants during the first few days of life: introducing an age related nomogram. Arch Dis Child Fetal Neonatal Ed. 2006; 91(4):F283-6. PMC: 2672732. DOI: 10.1136/adc.2005.085449. View

Monneret G, Labaune J, Isaac C, Bienvenu F, Putet G, Bienvenu J . Procalcitonin and C-reactive protein levels in neonatal infections. Acta Paediatr. 1997; 86(2):209-12. DOI: 10.1111/j.1651-2227.1997.tb08870.x. View

10.

Joram N, Boscher C, Denizot S, Loubersac V, Winer N, Roze J . Umbilical cord blood procalcitonin and C reactive protein concentrations as markers for early diagnosis of very early onset neonatal infection. Arch Dis Child Fetal Neonatal Ed. 2005; 91(1):F65-6. PMC: 2672656. DOI: 10.1136/adc.2005.074245. View

11.

DeLong E, Delong D, Clarke-Pearson D . Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988; 44(3):837-45. View

12.

Chiesa C, Panero A, Rossi N, Stegagno M, De Giusti M, Osborn J . Reliability of procalcitonin concentrations for the diagnosis of sepsis in critically ill neonates. Clin Infect Dis. 1998; 26(3):664-72. DOI: 10.1086/514576. View

13.

Hornik C, Fort P, Clark R, Watt K, Benjamin Jr D, Smith P . Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units. Early Hum Dev. 2012; 88 Suppl 2:S69-74. PMC: 3513766. DOI: 10.1016/S0378-3782(12)70019-1. View

14.

Madan J, Salari R, Saxena D, Davidson L, OToole G, Moore J . Gut microbial colonisation in premature neonates predicts neonatal sepsis. Arch Dis Child Fetal Neonatal Ed. 2012; 97(6):F456-62. PMC: 3724360. DOI: 10.1136/fetalneonatal-2011-301373. View

15.

Steinberger E, Hofer N, Resch B . Cord blood procalcitonin and Interleukin-6 are highly sensitive and specific in the prediction of early-onset sepsis in preterm infants. Scand J Clin Lab Invest. 2014; 74(5):432-6. DOI: 10.3109/00365513.2014.900696. View

16.

Chiesa C, Natale F, Pascone R, Osborn J, Pacifico L, Bonci E . C reactive protein and procalcitonin: reference intervals for preterm and term newborns during the early neonatal period. Clin Chim Acta. 2011; 412(11-12):1053-9. DOI: 10.1016/j.cca.2011.02.020. View

17.

Albenberg L, Kelsen J . Advances in Gut Microbiome Research and Relevance to Pediatric Diseases. J Pediatr. 2016; 178:16-23. DOI: 10.1016/j.jpeds.2016.08.044. View

18.

Kuppala V, Meinzen-Derr J, Morrow A, Schibler K . Prolonged initial empirical antibiotic treatment is associated with adverse outcomes in premature infants. J Pediatr. 2011; 159(5):720-5. PMC: 3193552. DOI: 10.1016/j.jpeds.2011.05.033. View

19.

Lapillonne A, Basson E, Monneret G, Bienvenu J, Salle B . Lack of specificity of procalcitonin for sepsis diagnosis in premature infants. Lancet. 1998; 351(9110):1211-2. DOI: 10.1016/S0140-6736(05)79165-0. View

20.

Mishra U, Jacobs S, Doyle L, Garland S . Newer approaches to the diagnosis of early onset neonatal sepsis. Arch Dis Child Fetal Neonatal Ed. 2006; 91(3):F208-12. PMC: 2672708. DOI: 10.1136/adc.2004.064188. View