Procalcitonin for Detecting Culture-Positive Sepsis in Neonates: A Prospective, Multicenter Study
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Le résumé fourni par la source
INTRODUCTION: It is unclear if serum procalcitonin (PCT) estimated at sepsis suspicion can help detect culture-positive sepsis in neonates. We evaluated the diagnostic performance of PCT in culture-positive sepsis in neonates. METHODS: This was a prospective study (February 2016 to September 2020) conducted in four level-3 units in India. We enrolled neonates suspected of sepsis in the first 28 days of life. Neonates with birth weight <750 g, asphyxia, shock, and major malformations were excluded. Blood for PCT assay was drawn along with the blood culture at the time of suspicion of sepsis and before antibiotic initiation. The investigators labeled the neonates as having culture-positive sepsis or "no sepsis" based on the culture reports and clinical course. PCT assay was performed by electrochemiluminescence immunoassay, and the clinicians were masked to the PCT levels while assigning the label of sepsis. Primary outcomes were the sensitivity, specificity, and likelihood ratios to identify culture-positive sepsis. RESULTS: The mean birth weight (SD) and median gestation (IQR) were 2,113 (727) g and 36 (32-38) weeks, respectively. Of the 1,204 neonates with eligible cultures, 155 (12.9%) had culture-positive sepsis. Most (79.4%) were culture-positive within 72 h of birth. The sensitivity, specificity, and positive and negative likelihood ratios at 2 ng/mL PCT threshold were 52.3% (95% confidence interval: 44.1-60.3), 64.5% (60.7-68.1), 1.47 (1.23-1.76), and 0.74 (0.62-0.88), respectively. Adding PCT to assessing neonates with 12.9% pretest probability of sepsis generated posttest probabilities of 18% and 10% for positive and negative test results, respectively. CONCLUSION: Serum PCT did not reliably identify culture-positive sepsis in neonates.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Procalcitonin for Detecting Culture-Positive Sepsis in Neonates: A Prospective, Multicenter Study
- Date Crossref
- 01/01/2023
- Éditeur
- S. Karger AG
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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All India Institute of Medical Sciences Department of Pediatrics pays non établi dans la noticeUniversité ou école supérieure
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Safdarjang Hospital pays non établi dans la noticeÉtablissement de santé
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Kalawati Saran Children's Hospital Department of Pediatrics pays non établi dans la noticeÉtablissement de santé
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Jawaharlal Institute of Post Graduate Medical Education and Research pays non établi dans la noticeUniversité ou école supérieure
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Lady Hardinge Medical College Department of Microbiology pays non établi dans la noticeUniversité ou école supérieure
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All India Institute of Medical Sciences Raipur pays non établi dans la noticeUniversité ou école supérieure
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National Institute of Medical Statistics pays non établi dans la noticeStructure de recherche
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All India Institute of Medical Sciences Bhopal pays non établi dans la noticeUniversité ou école supérieure
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Safdarjung Hospital and VMMC Department of Pediatrics pays non établi dans la noticeÉtablissement de santé
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Department of Neonatology pays non établi dans la noticeInstitution
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Department of Microbiology pays non établi dans la noticeInstitution
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Department of Biostatistics pays non établi dans la noticeInstitution
Department of Pediatrics — All India Institute of Medical Sciences, Safdarjang Hospital et Department of Pediatrics — Kalawati Saran Children's Hospital, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.