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Updated: Feb 11, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Procalcitonin and C-reactive protein as biomarkers for neonatal bacterial infection
Ashfaque F Quadir1,2, Philip N Britton1,2,3
1Discipline of Child and Adolescent, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Insights
Procalcitonin shows moderate accuracy for diagnosing neonatal sepsis, but requires further research. It should be used alongside other clinical factors for predicting bacterial infections in newborns.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Biomarker Research
Background:
- Neonates are highly susceptible to bacterial infections, a leading cause of global childhood morbidity and mortality.
- Procalcitonin (PCT) is proposed as a superior diagnostic marker for bacterial infections in febrile neonates compared to C-reactive protein (CRP).
Purpose of the Study:
- To evaluate the diagnostic utility of procalcitonin versus C-reactive protein in predicting bacterial infections in febrile neonates.
- To synthesize the best available evidence regarding PCT and CRP for diagnosing neonatal sepsis.
Main Methods:
- A literature search was conducted on Medline/PubMed using keywords: 'procalcitonin', 'C-reactive protein', 'bacterial infection', and 'neonatal sepsis'.
- Three relevant systematic reviews were identified, with the primary article for appraisal being the 2010 systematic review by Yu et al.
Main Results:
- The reviewed literature indicates that procalcitonin has moderate accuracy for diagnosing neonatal sepsis.
- Its use is recommended only in conjunction with other clinical parameters and investigations.
- Included studies exhibited variable quality, methodological heterogeneity, and potential publication bias.
Conclusions:
- Further research is necessary to establish definitive recommendations on the clinical utility of procalcitonin compared to CRP.
- The role of procalcitonin as a diagnostic marker for neonatal sepsis and bacterial infection requires more robust evidence before widespread clinical adoption.
Aim:
Neonates are predisposed to bacterial infection which are an important cause of early childhood morbidity and mortality globally. It has been proposed that procalcitonin has significant utility as a diagnostic marker for bacterial infection in febrile neonates when compared to C-reactive protein (CRP). The aim of this study is to conduct a literature search to find the best available evidence to answer the clinical question of the utility of procalcitonin when compared to CRP as a predictor of bacterial infection in febrile neonates.
Methods:
Medline/PubMed was searched using the terms 'procalcitonin', 'C-reactive protein', 'bacterial infection' and 'neonatal sepsis'. Three systematic reviews relevant to the clinical question were identified and the key article selected for critical appraisal was the systematic review by Yu et al. (2010).
Results:
The appraised literature concludes that procalcitonin has moderate accuracy in diagnosing neonatal sepsis, but suggests it should be considered only within the context of other clinical parameters and other relevant investigations. The studies included in the systematic review were of variable quality, showed considerable heterogeneity in their methods and evidence of possible publication bias.
Conclusion:
Further research is required before definitive recommendations can be made about the utility of procalcitonin compared with CRP as a diagnostic marker for neonatal sepsis and bacterial infection in clinical practice.
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