Department of Pediatrics, Mysore Medical College and Research Centre, Mysore 570001, India.
Department of Neonatology, Indira Gandhi Institute of Child Health, Bangalore 560029, India.
J Trop Pediatr. 2022 Apr 5;68(3). doi: 10.1093/tropej/fmac043.
We aimed to study the diagnostic utility of cerebrospinal fluid (CSF) procalcitonin (PCT) in neonates with meningitis. All the neonates with sepsis who qualified for lumbar puncture were prospectively evaluated. The neonates were classified into Meningitis and No meningitis group based on predefined criteria. CSF PCT was estimated in these neonates along with cytological and biochemical parameters. A total of 113 neonates were included in the study with 29 in the meningitis group and 84 in the no meningitis group. The median PCT levels were higher in babies with meningitis as compared to those without meningitis [0.194 (0.034-0.534) in meningitis group vs. 0.012 (0.012-0.012) ng/ml in no meningitis group, p < 0.001]. The area under curve for CSF PCT was 0.867 (0.77-0.95) and at a cut-off level of 0.120 ng/ml CSF PCT had a sensitivity of 83%, specificity of 84% and positive and negative predictive likelihood ratios of 5.35 and 0.20, respectively for the diagnosis of meningitis. CSF PCT has a good diagnostic accuracy similar to other parameters in the diagnosis of neonatal meningitis and can be considered as an additional diagnostic marker particularly when CSF culture is negative and cytochemical analysis is inconclusive.
我们旨在研究脑脊液（CSF）降钙素原（PCT）在脑膜炎新生儿中的诊断效用。所有符合腰椎穿刺条件的脓毒症新生儿均进行前瞻性评估。根据预设标准，将新生儿分为脑膜炎和无脑膜炎组。在这些新生儿中，同时评估了 CSF PCT 以及细胞化学和生化参数。共有 113 名新生儿纳入研究，其中脑膜炎组 29 名，无脑膜炎组 84 名。与无脑膜炎组相比，脑膜炎婴儿的 PCT 中位数水平更高[脑膜炎组为 0.194（0.034-0.534），无脑膜炎组为 0.012（0.012-0.012）ng/ml，p<0.001]。CSF PCT 的曲线下面积为 0.867（0.77-0.95），在 0.120ng/ml 的 CSF PCT 截断值下，CSF PCT 对脑膜炎的诊断具有 83%的敏感性、84%的特异性、5.35 的阳性预测似然比和 0.20 的阴性预测似然比。CSF PCT 在新生儿脑膜炎的诊断中具有与其他参数相似的良好诊断准确性，特别是在 CSF 培养为阴性且细胞化学分析不确定时，可以作为额外的诊断标志物。
