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Related Concept Videos

Synthesis and Functions of Calcitonin00:51

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Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
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Procalcitonin in Preterm Neonates: A Different Threshold and Prolonged Interpretation.

Blandine Bianco1, Bérengère François-Garret1, Marine Butin2

  • 1Neonatal Intensive Care Unit, CHU de Nice, Archet 2 Hospital, Nice, France.

Frontiers in Pediatrics
|June 3, 2021
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Summary

Procalcitonin (PCT) levels can help diagnose early-onset sepsis in premature neonates. A PCT level of 0.98 ng/mL is a key threshold, with samples taken within 6 hours of birth showing higher diagnostic accuracy.

Keywords:
biomarkerearly-onset sepsispretermprocalcitoninthreshold

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Area of Science:

  • Neonatal Medicine
  • Clinical Chemistry
  • Infectious Disease Diagnostics

Background:

  • Early-onset sepsis is a critical concern in premature neonates (<32 weeks gestation).
  • Accurate and timely diagnosis is essential for effective treatment and improved outcomes.
  • Procalcitonin (PCT) is a biomarker used in sepsis diagnosis, but its optimal threshold in preterm infants requires further evaluation.

Purpose of the Study:

  • To determine the positive threshold of procalcitonin (PCT) for diagnosing early-onset sepsis in neonates born before 32 weeks of gestation.
  • To assess the utility of PCT levels collected within 6 hours of birth for sepsis diagnosis in this vulnerable population.

Main Methods:

  • A retrospective, bicentric study involving 260 neonates (<32 weeks gestation) was conducted.
  • Two groups were analyzed: PCT levels at birth (CordPCT) and within 6 hours of life (delPCT).
  • Receiver Operating Characteristic (ROC) curves were used to determine PCT positive thresholds.

Main Results:

  • The overall positive PCT threshold was determined to be 0.98 ng/mL.
  • The threshold was 1.00 ng/mL for the CordPCT group and 0.98 ng/mL for the delPCT group.
  • PCT levels sampled within 6 hours of life (delPCT) demonstrated significantly higher diagnostic accuracy (AUC=0.94) compared to cord blood samples (AUC=0.75).

Conclusions:

  • The positive PCT threshold for early-onset sepsis in preterm neonates (<32 weeks gestation) is higher than in term infants.
  • PCT levels measured within 6 hours of birth appear valuable for inclusion in sepsis screening algorithms for preterm neonates.