Comparison between presepsin and procalcitonin in early diagnosis of neonatal sepsis

降钙素原 诊断试验中的似然比 医学 金标准(测试) 败血症 新生儿败血症 诊断优势比 接收机工作特性 内科学 优势比 预测值 全身炎症反应综合征 血培养 切断 前瞻性队列研究 试验预测值 曲线下面积 重症监护医学 抗生素 物理 微生物学 生物 量子力学
作者
Agustin Iskandar,Maimun Zulhaidah Arthamin,Kristin Indriana,Muhammad Anshory,Mina Hur,Salvatore Di Somma
出处
期刊:Journal of Maternal-fetal & Neonatal Medicine [Informa]
卷期号:32 (23): 3903-3908 被引量:34
标识
DOI:10.1080/14767058.2018.1475643
摘要

Background: Neonatal sepsis remains worldwide one of the leading causes of morbidity and mortality in both term and preterm infants. Lower mortality rates are related to timely diagnostic evaluation and prompt initiation of empiric antibiotic therapy. Blood culture, as gold standard examination for sepsis, has several limitations for early diagnosis, so that sepsis biomarkers could play an important role in this regard. This study was aimed to compare the value of the two biomarkers presepsin and procalcitonin in early diagnosis of neonatal sepsis.Methods: This was a prospective cross-sectional study performed in Saiful Anwar General Hospital Malang, Indonesia, in 51 neonates that fulfill the criteria of systemic inflammatory response syndrome (SIRS) with blood culture as diagnostic gold standard for sepsis.Results: At reviewer operating characteristic (ROC) curve analyses, using a presepsin cutoff of 706.5 pg/mL, the obtained area under the curve (AUCs) were sensitivity = 85.7%, specificity = 68.8%, positive predictive value = 85.7%, negative predictive value = 68.8%, positive likelihood ratio = 2.75, negative likelihood ratio = 0.21, and accuracy = 80.4%. On the other hand, with a procalcitonin cutoff value of 161.33 pg/mL the obtained AUCs showed: sensitivity = 68.6%, specificity = 62.5%, positive predictive value = 80%, negative predictive value = 47.6%, positive likelihood ratio = 1.83, the odds ratio negative = 0.5, and accuracy = 66.7%.Conclusions: In early diagnosis of neonatal sepsis, compared with procalcitonin, presepsin seems to provide better early diagnostic value with consequent possible faster therapeutical decision making and possible positive impact on outcome of neonates.

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