Omar Julia, Isa Salbiah, Ismail Tuan Salwani Tuan, Yaacob Najib Majdi, Soh Noor Azlin Azraini Che
Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Hospital USM, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Malays J Med Sci. 2019 Jul;26(4):61-69. doi: 10.21315/mjms2019.26.4.7. Epub 2019 Aug 29.
As an early recognition of neonatal sepsis is important for triggering the initiation of treatment, this study was thus designed to assess the diagnostic performance and discrimination value of procalcitonin (PCT) in neonatal sepsis cases.
This cross-sectional study, which was carried out at the Paediatric Intensive Care Unit of Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia, had involved 60 neonates admitted for suspected sepsis. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and the area under receiver operating characteristics curve (AUC) for PCT were determined at initial presentation (0 h) as well as 12 h and 24 h after presentation in comparison to blood culture as the gold standard.
The study consisted of 27 (45.0%) male and 33 (55.0%) female neonates with a mean (SD) age of 76.8 (48.25) h. At cut-off PCT value of > 2 ng/mL, the sensitivity, specificity, PPV and NPV were 66.7%, 66.7%, 33.3% and 88.9% at 0 h. The respective parameters were 83.3%. 56.3%, 32.3% and 93.1% at 12 h and 83.3%, 52.1%, 30.3% and 92.6% at 24 h. AUC was 71.6%, 76.6% and 71.7% at 0 h, 12 h and 24 h.
Diagnostic performance and discrimination values of PCT for diagnosis of neonatal sepsis varied with time of obtaining the blood samples. The PCT result at 12 h demonstrates the most optimal diagnostic performance and discrimination values.
由于早期识别新生儿败血症对于启动治疗至关重要，因此本研究旨在评估降钙素原（PCT）在新生儿败血症病例中的诊断性能和鉴别价值。
这项横断面研究在马来西亚吉兰丹州马来西亚理科大学医院（HUSM）的儿科重症监护病房进行，纳入了60例因疑似败血症入院的新生儿。以血培养作为金标准，在初始就诊时（0小时）以及就诊后12小时和24小时测定PCT的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）以及受试者操作特征曲线下面积（AUC）。
该研究包括27例（45.0%）男性和33例（55.0%）女性新生儿，平均（标准差）年龄为76.8（48.25）小时。在PCT临界值>2 ng/mL时，0小时的敏感性、特异性、PPV和NPV分别为66.7%、66.7%、33.3%和88.9%。12小时时相应参数分别为83.3%、56.3%、32.3%和93.1%，24小时时分别为83.3%、52.1%、30.3%和92.6%。0小时、12小时和24小时的AUC分别为71.6%、76.6%和71.7%。
PCT对新生儿败血症诊断的诊断性能和鉴别价值随采血时间而变化。12小时的PCT结果显示出最佳的诊断性能和鉴别价值。
