PP-040 Contribution of procalcitonin measured in umbilical cord blood in the management of asymptomatic early neonatal bacterial infections

Oussama Mghirbi; Myriam Barka; Sarra  Becheur; Donia Brahem; Maha Taamli; Amani Khlifi; Sonia Merchaoui; Jihen  ben Abdallah; manel Bellalah; Nabiha Mahdhaoui

PP-040 Contribution of procalcitonin measured in umbilical cord blood in the management of asymptomatic early neonatal bacterial infections

Oussama Mghirbi, Myriam Barka, Sarra Becheur, Donia Brahem, Maha Taamli, Amani Khlifi, Sonia Merchaoui, Jihen ben Abdallah, manel Bellalah, Nabiha Mahdhaoui

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Abstract

Article info

PP-040 Contribution of procalcitonin measured in umbilical cord blood in the management of asymptomatic early neonatal bacterial infections. Perinatal Journal 2024;32(2024):33 DOI: 10.59215/prn.24.032supp040

Author(s) Information

Oussama Mghirbi¹,

Myriam Barka¹,

Sarra Becheur²,

Donia Brahem¹,

Maha Taamli¹,

Amani Khlifi¹,

Sonia Merchaoui¹,

Jihen ben Abdallah²,

manel Bellalah¹,

Nabiha Mahdhaoui¹

Sousse University, Ibn El Jazzar Medical Faculty of Sousse, Department of Resuscitation and neonatal Medicine, University Hospital Center Farhat Hached, Sousse, Tunisia
Sousse University, Ibn El Jazzar Medical Faculty of Sousse, Department of Biochemistry Laboratory, University Hospital Center Farhat Hached, Sousse, Tunisia

Correspondence

Oussama Mghirbi, Sousse University, Ibn El Jazzar Medical Faculty of Sousse, Department of Resuscitation and neonatal Medicine, University Hospital Center Farhat Hached, Sousse, Tunisia, [email protected]

Publication History

Manuscript Received: April 24, 2024

Manuscript Accepted: May 03, 2024

Publication date: May 18, 2024

Conflicts of Interest

No conflicts declared.

Objective

Early neonatal bacterial infection (ENBI) remains a major cause of perinatal morbidity and mortality. Any delay in initiating therapy can have a negative impact on prognosis. The search for an optimal early marker in terms of sensitivity and specificity is therefore a topical issue. The aim of our study is to evaluate the contribution of Procalcitonin (PCT) measured in umbilical cord blood in the early diagnosis and management of asymptomatic ENBI.

Methods

This is a prospective evaluative study conducted over a 12-month period. We included all asymptomatic newborns with risk factors for ENBI, born at the Maternity and Neonatology Center of the Farhat Hached Hospital in Sousse, Tunisia. We performed a PCT dosage on umbilical cord blood at birth with a positivity threshold set at 0.5 ng/ml. The newborns included were managed according to a well-established national algorithm for the management of newborns with suspected ENBI. Subsequently, regardless of the PCT value, newborns were classified into three groups: certain, probable, and refuted ENBI according to the algorithm's criteria. Newborns with a diagnosis of certain or probable infection were considered infected.

Results

During the study period, 9685 live births were recorded, and 1235 newborns were suspected of having ENBI, representing 12.7% of live births. The number of asymptomatic newborns at risk of ENBI was 599. Of these, 279 newborns were included in our study. ENBI was diagnosed in 20 cases, representing 1.61% of at-risk situations and 2.06 ‰ of live births. Chorioamnionitis was the only risk factor statistically correlated with ENBI (p=0.003). For a threshold value of 0.5 ng/mL, the sensitivity, specificity, positive predictive value, and negative predictive value of cord PCT were 55%, 96.5%, 55% and 96.5% respectively. The threshold value for PCT found by the receiver operating characteristic curve (ROC curve) was 0.415 ng/mL. For this threshold, we found a sensitivity of 60% and a specificity of 96.5%.

Conclusion

Our work demonstrates that the use of Procalcitonin (PCT) in umbilical cord blood can help in early diagnosing Early Neonatal Bacterial Infection (ENBI). Chorioamnionitis was also among the important factors. The diagnose threshold for PCT was found to be 0.415 ng/mL. More studies are needed to support these findings and enhance neonatal outcomes.

Keywords

newborn, bacterial infection, Procalcitonin

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PP-040 Contribution of procalcitonin measured in umbilical cord blood in the management of asymptomatic early neonatal bacterial infections

Article info

Author(s) Information

Correspondence

Publication History

Conflicts of Interest

Objective

Methods

Results

Conclusion

Keywords