1. Procalcitonin in detecting neonatal nosocomial sepsis.
- Author
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Auriti C, Fiscarelli E, Ronchetti MP, Argentieri M, Marrocco G, Quondamcarlo A, Seganti G, Bagnoli F, Buonocore G, Serra G, Bacolla G, Mastropasqua S, Mari A, Corchia C, Prencipe G, Piersigilli F, Ravà L, and Di Ciommo V
- Subjects
- Calcitonin Gene-Related Peptide, Humans, Infant, Newborn, Infant, Very Low Birth Weight, Intensive Care Units, Neonatal, Likelihood Functions, ROC Curve, Sensitivity and Specificity, Calcitonin blood, Cross Infection diagnosis, Protein Precursors blood, Sepsis diagnosis
- Abstract
Objective: To investigate the accuracy of procalcitonin (PCT) as a diagnostic marker of nosocomial sepsis (NS) and define the most accurate cut-off to distinguish infected from uninfected neonates., Setting: Six neonatal intensive care units (NICUs)., Patients: 762 neonates admitted to six NICUs during a 28-month observational study for whom at least one serum sample was taken on admission., Main Outcome Measures: Positive and negative predictive values at different PCT cut-off levels., Results: The overall probability of an NS was doubled or more if PCT was >0.5 ng/ml. In very-low-birth-weight (VLBW) infants, a cut-off of >2.4 ng/ml gave a positive predictive value of NS near to 50% with a probability of a false-positive diagnosis of NS in about 10% of the patients., Conclusions: In VLBW neonates, a serum PCT value >2.4 ng/ml prompts early empirical antibiotic therapy, while in normal-birth-weight infants, a PCT value ≤2.4 ng/ml carries a low risk of missing an NS.
- Published
- 2012
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