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Cord blood procalcitonin level and early-onset sepsis in extremely preterm infants

Frerot, Alice
Colella, Marina
Taibi, Ludmia
Bonacorsi, Stéphane
Alberti, Corinne
Mohamed, Damir
Biran, Valérie
Published in European Journal of Clinical Microbiology & Infectious Diseases. 2019, vol. 38, no. 9, p. 1651-1657
Abstract Early-onset neonatal sepsis (EOS) is observed in 1.7% of extremely preterm infants, with high morbidity and mortality rate. Cord blood procalcitonin (PCT) is a sensitive marker of EOS in full-term newborns, but it has been rarely studied in premature infants. The diagnostic value of cord blood PCT by immunofluorescence has been assessed as an early marker of EOS in a prospective cohort of extremely preterm infants, with a threshold at 0.5 μg/L. EOS was defined by a positive bacterial culture or by the association of postnatal biological/clinical signs of EOS and antibiotic treatment for more than 72 h. Correlation between PCT serum concentrations and postnatal morbidities was also analyzed. Among a total of 186 infants, 45 (24%) were classified as EOS. Blood PCT concentration was ≤ 0.5 μg/L in 114 infants, including 11 EOS (9.6%) and PCT was > 0.5 μg/L in 72 babies including 34 EOS (47.2%). PCT concentration > 0.5 μg/L was associated with higher risk of EOS (OR 2.18; CI95% 1.58-3.02; p < 0.0001). The receiver operating characteristic curve determined a cutoff of 0.7 μg/L as the best compromise, with an area under the curve of 0.75 (sensitivity 69%, specificity 70%). In multivariate analysis, clinical chorioamnionitis was associated with PCT concentration > 0.5 μg/L (OR 2.58; CI95% 1.35-4.94; p = 0.004). Cord blood PCT is a marker significantly associated with EOS in extremely preterm infants, but its sensitivity remains low. Its added value in combination with other early marker of EOS needs to be further investigated in this high-risk population.
Keywords Biomarkers/bloodFemaleFetal Blood/chemistryHumansInfant, Extremely PrematureInfant, NewbornNeonatal Sepsis/diagnosis/microbiologyPregnancyProcalcitonin/bloodProspective StudiesROC CurveSensitivity and SpecificityEarly-onset sepsisNeonatologyProcalcitoninExtremely preterm infantsBiological marker
PMID: 31154524
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Research group Prévention des complications néonatales d'origine périnatale (990)
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FREROT, Alice et al. Cord blood procalcitonin level and early-onset sepsis in extremely preterm infants. In: European Journal of Clinical Microbiology & Infectious Diseases, 2019, vol. 38, n° 9, p. 1651-1657. doi: 10.1007/s10096-019-03593-0 https://archive-ouverte.unige.ch/unige:137441

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Deposited on : 2020-06-22

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