Procalcitonin in detecting neonatal nosocomial sepsis
Procalcitonin in detecting neonatal nosocomial sepsis
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DOI：
10.1136/fetalneonatal-2010-194100
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发表时间：
2012-09-01
影响因子：
4.4
通讯作者：
Di Ciommo, Vincenzo
中科院分区：
文献类型：
--
作者：
Auriti, Cinzia;Fiscarelli, Ersilia;Di Ciommo, Vincenzo
目的探讨降钙素原（PCT）作为医院败血症（NS）诊断指标的准确性，确定区分新生儿感染与未感染的最准确临界值。6个新生儿重症监护病房（NICUs）。在一项为期28个月的观察性研究中，762名新生儿住进了6个新生儿重症监护病房，入院时至少采集了一份血清样本。不同PCT临界值的阳性和阴性预测值。结果PCT≥0.5 ng/ml时发生NS的可能性增加一倍以上。在极低出生体重（VLBW）婴儿中，截断值为>2.4 ng/ml的NS阳性预测值接近50%，约10%的患者出现NS假阳性诊断的概率。结论在VLBW新生儿中，血清PCT值>2.4 ng/ml提示早期经验性抗生素治疗，而在正常出生体重的婴儿中，PCT值为1
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