Procalcitonin Levels in Neonatal Gram-Positive and Gram-Negative Bacterial Sepsis- a Differentiating Marker?

Abstract

Neonatal sepsis diagnosis has remained challenging despite advances in neonatal care and scientists have sought the use of biomarkers in its diagnosis. Procalcitonin has shown the most promise amongst the biomarkers and has been proposed to even differentiate between gram negative and positive infection in adults. The aim of the study is to find out if procalcitonin can be used to differentiate between gram positive and negative infection in neonates as in adults. The study was carried out in a tertiary hospital in Zaria, Kaduna state, Nigeria over a period of ten months. Two hundred and forty-eight neonates with clinical features of sepsis were enrolled into the study and had their blood samples taken for investigation which include complete blood count, C-reactive protein, procalcitonin and blood culture. Common clinical features as it is found with sepsis were non-specific and include fever, poor suck, jaundice, and depressed primitive reflexes. Ninety-four neonates had confirmed sepsis with gram negative organism accounting for 52.3% of the isolates. Procalcitonin level differed between gram negative and positive infection, Enterobacteriaceae and non-fermentative gram-negative aerobes and between various isolates, but it was found to be statistically not significant using Kruskal Wallis-H test. Evidence as at now does not support our supposition therefore, more studies need to be carried out to substantiate or refute our finding.