560 - Unreliability of Procalcitonin in the diagnosis of Neonatal Sepsis in the tropics.

Poster Number: 560
Publication Number: 560.428

Nonye I. Ezeh, The Royal Wolverhampton NHS Trust, Wolverhampton, England, United Kingdom; Henry C. Okpara, Nnamdi Azikiwe University, AWKA, Imo, Nigeria; Sunday O. Ochigbo, University of Calabar Teaching hospital, Calabar, Nigeria, Calabar, Cross River, Nigeria; Emeka C. Ezeh, Walsall Manor Hospital, Wolverhampton, England, United Kingdom; Maxwell U. Anah, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria

Background: Neonatal sepsis is an important cause of morbidity and mortality in developing countries. Early
diagnosis and treatment is necessary in order to mitigate this trend.

Objective: To determine the usefulness of procalcitonin (PCT) as an early marker in the diagnosis of neonatal sepsis in a tertiary teaching hospital in Nigeria.

Design/Methods: A prospective case-control hospital-based study among 60 neonates with suspected sepsis admitted into the newborn unit and healthy 60 age and sex-matched controls. At presentation, samples for PCT test were collected along with samples for routine sepsis workup and blood smear for malaria parasite. Samples for PCT were pooled and analysed using quantitative ELISA test. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were determined at a PCT level of 0.5ng/ml. P value was at < 0.05 with 95 % confidence interval.

Results: Nineteen (31.7% of 60) had blood culture positive sepsis, 36 (60.0%) had blood culture negative sepsis and 5 (8.3%) had neonatal malaria. The commonest organism identified was Staphylococcus aureus. The median PCT levels in the subjects and controls were 0.98ng/ml and 0.40ng/ml respectively but 1.28ng/ml in blood culture negative sepsis and 0.93ng/ml in blood culture positive sepsis. Based on the receiver operating characteristics curve, PCT levels ≥0.5ng/ml was suggestive of bacterial infection. Sensitivity, specificity, PPV, NPV and area under the curve at PCT level of 0.5ng/ml were 68.4%, 29.3%, 30.0%, 66.7% and 0.51 respectively.Conclusion(s): PCT levels were higher in blood culture negative sepsis than blood culture positive sepsis though both were higher than healthy babies. Thus, PCT was insignificant as an acute phase reactant because of its low specificity and PPV.
Dr Nonye EZEH's CVDr Nonye EZEH's CV.pdf
Comparison of serum procalcitonin levels among study subjects’ diagnosis category*=Statistically significant