Procalcitonin as a diagnostic tool for bacterial neonatal sepsis

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Nely Nelly
Guslihan Dasa Tjipta
Hakimi Hakimi
Bugis Mardina Lubis


Background Bacterial sepsis is the main cause of morbidity and mortality in neonates. Early diagnosis and appropriate treatment can reduce the mortality rate. Blood culture is the gold standard for diagnosis of bacterial sepsis, but it requires 3-5 days for results. Since the disease may progress rapidly in neonates, a faster diagnostic test is needed. Measurement of procalcitonin levels may be a quick method to diagnose bacterial sepsis in neonates. Some studies found the sensitivity of procalcitonin to be between 92-100%. Objective To assess the use of procalcitonin as an early diagnostic tool for bacterial neonatal sepsis. Methods This diagnostic study was conducted from October 2011 to February 2012. Forty-three neonates in the Perinatology Unit at H. Adam Malik Hospital were suspected to have bacterial sepsis. They underwent routine blood counts, blood cultures, as well as C-reactive protein and procalcitonin measurements. Subjects were collected by consecutive sampling. The gold standard of sepsis was based on any microorganism found in blood culture. Results Of 43 neonates, 36 neonates had bacterial sepsis. We found that procalcitonin sensitivity was 100%, specificity 85.71%, positive predictive value 97.29% and negative predictive value 100%. The ROC curve showed a cut-off point of 0.929 (95%CI 0.713 to 0.953). Conclusion Procalcitonin is useful as an early diagnostic tool for bacterial neonatal sepsis.

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Nelly N, Tjipta G, Hakimi H, Lubis B. Procalcitonin as a diagnostic tool for bacterial neonatal sepsis. PI [Internet]. 1Oct.2015 [cited 19Jul.2019];55(5):268-2. Available from:
Received 2016-02-01
Accepted 2016-02-01
Published 2015-10-01


1. Osrin D, Vergnano S, Costello A. Serious bacterial infections in newborn infants in developing countries. Curr Opin Infect Dis. 2004;17:217-24.
2. Zahedpasha Y, Ahmadpour-Kacho M, Hajiahmadi M, Haghshenas M. Procalcitonin as a marker of neonatal sepsis. Iran J Pediatr. 2009; 19:117-22.
3. Robinson DT, Kumar P, Cadichon SB. Neonatal sepsis in the emergency department. Clin Ped Emerg Med. 2008;9:160-8.
4. Stoll BJ. Infections of the neonate. In: Behrman RE, Kiegman RM, Jenson HB, Stanton BF, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: Saunders Company; 2007. p. 794-811.
5. Klinger G, Levy I, Sirota L, Boyko V, Lerner-Geva L, Reichman B, et al. Outcome of early-onset sepsis in a national cohort of very low birth weight infants. Pediatrics. 2010;125:e736-40.
6. Baruti Gafurri Z, Pacarizi H, Zhubi B, Begolli L, Topciu V. The importance of determining procalcitonin and Creactive protein in different stages of sepsis. Bosn J Basic Med Sci. 2010;10:60-4.
7. Afroza S. Neonatal sepsis a global problem: an overview. Mymensingh Med J. 2006;15:108-14.
8. Abdollahi A, Shoar S, Nayyeri F, Shariat M. Diagnostic value of simultaneous measurement of procalcitonin, interleukin-6 and hs-CRP in prediction of early-onset neonatal sepsis. Mediterr J Hematol Infect Dis. 2012;4:e2012028.
9. Reinhart K, Karzai W, Meisner M. Procalcitonin as marker of the systemic inflammatory response to infection. Intensive Care Med. 2000;26:1193-200.
10. Chiesa C, Pellegrini G, Panero A, Osborn JF, Signore F, Assumma M, et al. C-reactive protein, interleukin-6, and procalcitonin in the immediate postnatal period: influence of illness severity, risk status, antenatal and perintal complications, and infection. Clin Chem. 2003;49:60-8.
11. Joram N, Boscher C, Denizot S, Loubersac V, Winer N, Roze JC, et al. Umbilical cord blood procalcitonin and Creactive protein concentrations as markers for early diagnosis of very early onset neonatal infection. Arch Dis Child Fetal Neonatal Ed. 2006;91:F65-6.
12. Balci C, Sungurtekin H, Gurses E, Sungurtekin U, Kaptanaglu B. Usefulness of procalcitonin for diagnosis of sepsis in the intensive care unit. Crit Care. 2003;7:85-90.
13. Amirullah A. Sepsis pada bayi baru lahir. In: Kasim SM, Yunanto A, Dewi R, Sarosa IG, Usman A, editors. Buku ajar neonatologi. Jakarta: Ikatan Dokter Anak Indonesia; 2008. p. 170-87.
14. Koksal N, Harmanci R, Cetinkaya M, Hacimustafaoglu M. Role of procalcitonin and CRP in diagnosis and follow-up of neonatal sepsis. Turk J Pediatr. 2007;49:21-9.
15. Carrol ED, Thomson AP, Hart CA. Procalcitonin as a marker of sepsis. Int J Antimicrob Agents. 2002;20:1-9.
16. Klinger G, Levy I, Sirota L, Boyko V, Geva LL, Reichman B. Outcome of early onset sepsis in neonatal cohort of very low birth weight infants. Pediatrics. 2010;125:e736-40.
17. Bender L, Thaarup J, Varming K, Krarup H, EllermannEriksen SE, Ebbesen F. Early and late markers for detection of early-onset neonatal sepsis. Dan Med Bull. 2008;55:219-23.
18. Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Changes in pathogens causing early onset sepsis in very-low-birth-weight infants. N Engl J Med. 2002;347:240-7.
19. Saez-Llorens X, Vargas S, Guerra F, Coronado L. Application of new sepsis definition for evaluate outcome of pediatric patients with severe systemic infection. Pediatr Infect Dis. 1995;14:557-61.
20. Ramesh Bhat Y, Leslie Edward SL, Vandana KE. Bacterial isolates of early-onset neonatal sepsis and their antibiotic susceptibility pattern between 1998 and 2004: an audit from a center in India. Italian J Pediatr. 2011;37:1-6.
21. Vazzalwar R, Pina-Rodrigues E, Puppala BL, Angst DB, Schweig L. Procalcitonin as a screening test for late onset sepsis in preterm very low birth weight infants. J Perinatol. 2005;25:397-402.
22. Rey C, Arcos ML, Concha-Torre A. Procalcitonin as a diagnostic and prognostic marker in critically ill children. Eur Pediatr. 2010;4:62-5.