Abstract:
Background: Sepsis is a significant cause of morbidity and mortality in the neonate, especially in premature infants. In recent years, studies have shown that serum procalcitonin (PCT) may be of value as an early marker of neonatal sepsis when taken at the onset of clinical signs of infection. A definite PCT value has not been established in relation to specific gestational age or birth weight categories. This study determined if serum PCT level using cord blood is reliable for the diagnosis of early onset sepsis in very low birth weight infants even before clinical manifestations develop.
Setting: The study was conducted in a government tertiary hospital over a total period of 5 months (June to October 2023).
Objective: To determine if there is an association between umbilical cord blood PCT levels and early onset sepsis in very low birth weight infants
Study design: Prospective cohort study
Methodology: Umbilical cord blood was extracted for serum procalcitonin, blood culture and C-reactive protein (CRP). Mean values of the laboratory test results were calculated and Chi-square test applied. The sensitivity, specificity, positive and negative likelihood ratios, and positive and negative predictive values of procalcitonin with the corresponding 95% confidence interval ranges were computed.
Results: Thirty-nine very low birth weight infants born in the hospital and admitted in the Neonatal Intensive Care Unit were included. Subjects were classified into 3 groups according to their sepsis status. The study determined 0.5 - 2 ng/ml as the best cut-off, from the 18 subjects from the Suspected Sepsis group, 8 have shown PCT values of >5ng/ml.
Conclusion: Culture growth still remains to be the gold standard in diagnosing sepsis, our study suggests that Procalcitonin could be a useful sensitive test with clinically diagnosed sepsis, it may be used as an adjunct in the early determination of early onset neonatal sepsis for very low birthweight patients.
Key words: serum procalcitonin; early onset neonatal sepsis; very low birth weight infant; cord blood
