Online ISSN: 2515-8260

Keywords : neonate

Role of procalcitonin in diagnosis of late onset sepsis in neonates

Dr. Bheemaraya Shivasharana, Dr. Vasanth Kumar D. L, Dr.Manjunathaswamy. R, Dr. Ananya U Shetty,Ravindra B Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 993-998

Background: Neonatal sepsis refers to systemic infection of the new born. It is characterized
by a constellation of non-specific symptomatology in association with bacteremia.Neonatal
sepsis is the most common cause of (52%) neonatal mortality in our country, which could be
reduced in large proportion by a high index of suspicion, prompt diagnosis and aggressive
management of this condition. Many studies have come up regarding the usefulness of
procalcitonin in the early diagnosis of neonatal sepsis and have found it to be 87-100
sensitive and also highly specific.
Methods: A prospective clinical study was conducted in Neonatal Intensive Care Unit of
Shimoga Institute of Medical Sciences, Shimoga. From November 2020 to November 2021 to
study role of Procalcitonin in diagnosis of LOS.All intramural neonates admitted to NICU
during this period with clinically suspected Late onset sepsis were included in the study and
were subjected to sepsis screen, blood culture and procalcitonin. Study population was further
divided into 3 group as Proven sepsis (sepsis screen positive and blood culture positive),
Probable sepsis group (sepsis screen positive, blood culture negative) and no sepsis group
(sepsis screen negative and blood culture negative, with alternate diagnosis).Sensitivity,
specificity of Procalcitonin at a level of 2ng/ml in diagnosis of late onset sepsis in neonates
was calculated (Proven sepsis was taken as test group and No sepsis group was taken as
control group).
Results: PCT was found to be >2ng/ml in 58.6% of the enrollees,our study had high PCT of
19.2ng/ml in proven sepsis,our study had sensitivity of PCT as high as 78.57% with
specificity of PCT to the tune of 77.78%.
Conclusion: The procalcitonin values were higher in sepsis proven group than in probable
sepsis and no sepsis group. Sensitivity, Specificity, PPV and NPV of Procalcitonin at value
of.2ng/ml in diagnosis of LOS was found to be 78.57%, 77.78%, 76.74%, 78.57.

To assess the applicability of Whitt’s neonatal trigger score (W-NTS) for early detection of at- risk neonates in Indian setup

Dr. Ragini Ballaiya, Dr. Amit Agrawal, Dr. J Shrivastava

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 5045-5050

Background- Neonates show clinical signs prior to acute deterioration which are usually unrecognized. Whitt’s neonatal trigger score (W-NTS) with high sensitivity(77%) and specificity(97%) was developed in 2010 for early detection of neonates who are at risk of deterioration. The aim of our study was to assess the applicability of W-NTS for early detection of at risk neonates in Indian population. Method- A ProspectiveObservational study was conducted over a period of 24 months on stable neonates with predefined risk factors in the postnatal ward. The scores were calculated using 6 clinical parameters Heart rate, Respiratory rate, Temperature, Respiratory distress, Level of activity, and RBS readings  and were recorded on W-NTS chart. Each parameter score minimum of 0, and maximum ranging from 1 to 3. The score from each separate parameter was then combined to generate a cumulative score (minimum 0, maximum 15). Neonates were divided into 3 groups Group 1 (score 0): who remained well in the PNW, Group 2 (score 1): neonates requiring septic screen and antibiotics therapy, Group 3(score ≥2): required admission to the NICU. Results- Out of 853 neonates ,683(80.07%) belonged to group 1, 23(2.7%) belonged to group 2, whereas 136(17.23%) belonged to group 3(P<0.001). Septic screen was done for all neonates in group 2 and 3. Neonates who belonged to group 2 had negative results were successfully discharged, whereas in group 3 ,62 out of 143 had positive septic screening results, out of which 11 died and 136 were successfully discharged. Conclusion-This W-NTS score is highly usefull for early detection of deterioration in neonates with high risk factors. The score is highly reliable and easy to perform.