Background We evaluated procalcitonin (PCT) assay in the emergency
diagnosis of neonatal bacterial infection, especially in preterm infants, relative to
C-reactive protein (CRP) and fibrinogen. Methods One hundred and twenty
neonates (32 preterm), of whom 21 were infected, were tested. Results
Concentrations of PCT, CRP and fibrinogen in uninfected infants were not affected by
gestational age at birth. Concentrations of CRP and PCT increased rapidly during the
first 24 h of life, while fibrinogen concentrations increased gradually from birth.
All marker concentrations were significantly greater in neonates with bacterial
infection. Receiver-operating characteristic analysis showed that optimum cut-off
values for fibrinogen, CRP and PCT were 3.0 g/L, 7.5 mg/L and 2.5 µg/L respectively,
for the diagnosis of sepsis at birth. Conclusions Determination of PCT
is of value in excluding bacterial infection in neonates since it has a negative
predictive value of 93%.
