Diagnostic accuracy of biomarkers for early-onset neonatal bacterial infections: Evaluation of serum procalcitonin reference curves

Hidetoshi Go, Nobuhiko Nagano, Daichi Katayama, Takuya Akimoto, Takayuki Imaizumi, Ryoji Aoki, Midori Hijikata, Ayako Seimiya, Ryota Kato, Aya Okahashi, Ichiro Morioka

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

To date, no clinical studies have compared the accuracy of serum procalcitonin (PCT) reference curves. We aimed to validate the diagnostic accuracy of previously reported serum PCT reference curves and to determine which biomarkers among a cut-off value over the 95th percentile in the serum PCT reference curve, white blood cell (WBC) count, and C-reactive protein (CRP) and immunoglobulin M (IgM) levels, have the highest diagnostic accuracy for early-onset neonatal bacterial infections. This retrospective cohort study assessed 16 preterm and 23 term infants with suspected bacterial infections within 72 h after birth. Each infant group was divided into two subgroups: confirmed- and non-infection. The diagnostic accuracy was determined using the Youden index. The reference curves by Fukuzumi et al. in preterm and term infants had the highest Youden indexes: 1.000 and 0.324, respectively. Among preterm infants, the Youden index for PCT was 1.000. Among term infants, the Youden index for a combination of PCT, CRP, and WBC and/or IgM was 1.000. In conclusion, a serum PCT level over the 95th percentile on the reference curve for preterm infants and a combination of PCT and CRP levels with WBC count and/or IgM levels for term infants provided sufficient diagnostic accuracy.

Original languageEnglish
Article number839
JournalDiagnostics
Volume10
Issue number10
DOIs
Publication statusPublished - 18 Oct 2020

Keywords

  • C-reactive protein
  • Immunoglobulin M
  • Sensitivity
  • Sepsis
  • Specificity
  • White blood cell
  • Youden index

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