P447 Role of serum procalcitonin as marker of neonatal sepsis

Background Despite the advances in perinatal and neonatal care and use of newer potent antibiotics, the incidence of neonatal sepsis remains high and the outcome is still severe. Early diagnosis of neonatal sepsis followed by appropriate treatment decreases mortality and morbidity in infants. Objective To study the ROLE OF SERUM PROCALCITONIN AS A MARKER OF NEONATAL SEPSIS and To compare procalcitonin with CRP as a diagnostic marker for neonatal sepsis Methodology Hospital Based prospective observational study. 50 neonates (preterm &term) with clinically suspected sepsis were studied during 1 year from Jan 2016 to Dec 2016 in Chaitanaya Hospital Chandigarh. Conventional sepsis workup was done in all cases and the diagnosis of neonatal sepsis was proved based on the results of blood culture. The serum Procalcitonin was measured by quantitative Enzyme linked iimunofluroscence assay and the results were compared to CRP levels between the neonates with or without proven sepsis. Results Of the total 220 babies admitted in NICU during that period 50 were eligible for study and analyzed.. 24% babies had Definite Sepsis, 60% had Probable Sepsis and 16% babies had No Sepsis. Of the neonates with suspected sepsis 24% had culture positive and 76% were culture negative. Mean PCT level was 13.27+- 33.2 ng/ml. The mean PCT levels were higher in Meningitis group (Mean PCT-26.45) than no meningitis group.(p value-0.216).The mean PCT levels was highest in neonates whose TLC>5000 (Mean PCT-18.5) (p value-0.002). The mean PCT levels were higher in all 3 infection groups in neonates with CRP>0.5 mg/dl (positive) than that of neonates with CRP≤0.5 mg/dl (negative). Mean PCT levels were 0.433, 52.22 and 27.95 in no infection, probable infection and definite infection group respectively. (p value- 0.001) Evaluating CRP as a diagnostic marker for definite neonatal sepsis with cut off value as 0.5 mg/dl, had sensitivity of 41.67%, Specificity of 89.47%, Positive Predictive Value of 55.56% and Negative Predictive value of 82.93%.Evaluating PCT as a diagnostic marker for definite neonatal sepsis. The Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value were 83.3%, 26.32%, 26.32% and 83.3% respectively taking cut- off level of procalcitonin to be >0.5 ng/ml. Conclusion The importance of procalcitonin in diagnosing neonatal septicaemia becomes more useful when it is used along with other investigations. Especially in identifying the group of neonates who may not be infected and may not require antibiotics.