Procalcitonin as a Biomarker for Predicting Clinical Utility in Cases of Neonatal Sepsis: Outcomes from a Single-Centric Procalcitonin Monitoring Study

Authors

DOI:

https://doi.org/10.37506/wq9yvx74

Keywords:

Anti-bacterial agents, Biomarkers, Length of stay, Neonatal sepsis, Procalcitonin

Abstract

Background:

Neonatal sepsis remains one of the main causes of morbidity and mortality among newborns globally. The escalating threat of antibiotic resistance prompted the need for more reliable diagnostic and prognostic tools. Procalcitonin (PCT) was reported to be superior to C-reactive protein (CRP), being more specific for sepsis.

Methodology:

Fifty septicaemic neonates were selected for the study. Serum procalcitonin levels were measured upon hospital admission, and parameters including antibiotic requirement, hospital stay, and clinical outcomes were recorded. The mean PCT level recorded was 1.3135 ng/mL, and was found to be significantly higher in neonates with poor outcomes compared to those with good outcomes (p-value < 0.001). A positive correlation was noted between elevated PCT levels and increased length of hospital stay. Kaplan-Meier survival analysis and log-rank tests also verified statistically significant differences in outcomes and hospital stay based on PCT values (p-value < 0.0005).

Conclusion:

Serum procalcitonin at admission, therefore, serves as a valuable predictor of severity in neonatal sepsis. Raised PCT levels are associated with prolonged hospitalisation and poorer outcomes, enforcing antimicrobial stewardship.

Author Biographies

  • Subhranil Mal, 3rd Year MBBS Student, Medical College, Kolkata,

    3rd Year MBBS Student, Medical College, Kolkata,

  • Neha Karar, Associate Professor, Dept. of Biochemistry, Medical College, Kolkata,

    Associate Professor, Dept. of Biochemistry, Medical College, Kolkata,

  • Biyanka Sau, Assistant Professor, Dept. of Microbiology, Medical College, Kolkata

    Assistant Professor, Dept. of Microbiology, Medical College, Kolkata

  • Arpita Bain, Junior Resident, Dept. of Pharmacology, Medical College, Kolkata.

    Junior Resident, Dept. of Pharmacology, Medical College, Kolkata.

  • Suhena Sarkar, Associate Professor, Dept. of Pharmacology, Medical College, Kolkata

    Associate Professor, Dept. of Pharmacology, Medical College, Kolkata

References

Angeletti S, Ciccozzi M, Fogolari M, Spoto S, Presti AL, Costantino S, et al (2016). Procalcitonin and MR-proAdrenomedullin combined score in the diagnosis and prognosis of systemic and localized bacterial infections. Journal of Infection, 72(3): 395–8. https://doi.org/10.1016/j.jinf.2015.12.006

Assicot M, Bohuon C, Gendrel D, Raymond J, Carsin H, Guilbaud J (1993). High serum procalcitonin concentrations in patients with sepsis and infection. Lancet, 341(8844): 515–8. https://doi.org/10.1016/0140-6736(93)90277-n

Azevedo JR, Torres OJ, Czeczko NG, Tuon FF, Nassif PAN, de Souza GD (2012). Procalcitonin as a prognostic biomarker of severe sepsis and septic shock. Revista do Colégio Brasileiro de Cirurgiões, 39(6): 456–61. https://doi.org/10.1590/s0100-69912012000600003

Bartolovic D, Ignjatovic S, Stankovic S, Nada MS (2011). Procalcitonin and other biomarkers of sepsis in newborns in the intensive care unit. Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine, 22(1): 24–30. https://pubmed.ncbi.nlm.nih.gov/27683386/

Clec’h C, Ferriere F, Karoubi P, Fosse JP, Cupa M, Hoang P, et al (2004). Diagnostic and prognostic value of procalcitonin in patients with septic shock. Critical Care Medicine, 32(5): 1166–9. https://doi.org/10.1097/01.ccm.0000126263.00551.06

Dessu S, Habte A, Melis T, Gebremedhin M (2020). Survival status and predictors of mortality among newborns admitted with neonatal sepsis at public hospitals in Ethiopia. International Journal of Pediatrics, 1-10. https://doi.org/10.1155/2020/8327028

Dhudasia MB, Benitz WE, Flannery DD, Christ L, Rub D, Remaschi G, et al (2023). Diagnostic performance and patient outcomes with C-reactive protein use in early-onset sepsis evaluations. Journal of Pediatrics, 256: 98-104. https://doi.org/10.1016/j.jpeds.2022.12.007

Fendler WM, Piotrowski AJ (2008). Procalcitonin in the early diagnosis of nosocomial sepsis in preterm neonates. Journal of Paediatrics and Child Health, 44(3): 114-118. https://doi.org/10.1111/j.1440-1754.2007.01230.x

Hofer N, Zacharias E, Müller W, Resch B (2012). An update on the use of C-reactive protein in early-onset neonatal sepsis: current insights and new tasks. Neonatology, 102: 25-36. http://dx.doi.org/10.1159%2F000336629

Jekarl DW, Lee S, Kim M, Kim Y, Woo SH, Lee WJ (2019). Procalcitonin as a prognostic marker for sepsis based on SEPSIS-3. Journal of Clinical Laboratory Analysis, 33(9): e22996. https://doi.org/10.1002/jcla.22996

Jensen JU, Hein L, Lundgren B, Bestle MH, Mohr TT, Andersen MH, et al (2011). Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: a randomized trial. Critical Care Medicine, 39(9): 2048–58. https://doi.org/10.1097/ccm.0b013e31821e8791

Li J, Xiang L, Chen X, Li S, Sun Q, Cheng X, Hua Z. Global, regional, and national burden of neonatal sepsis and other neonatal infections, 1990–2019: findings from the global burden of disease study 2019 (2023). European Journal of Pediatrics, 182(5): 2335-43. https://doi.org/10.1007/s00431-023-04911-7

Mahmoud HAH, Parekh R, Dhandibhotla S, Sai T, Pradhan A, Alugula S, et al (2023). Insight into neonatal sepsis: an overview. Cureus, 15(9): e45530. https://doi.org/10.7759/cureus.45530

Manoli PA, Metgud SC, Bhandankar M, Manoli AD (2024). Effectiveness of serum procalcitonin, C-reactive protein and hematological parameters versus blood culture in early diagnosis of neonatal sepsis in neonatal intensive care unit. Obstetrics and Gynaecology Forum, 34(3s): 793-8

Meisner M, Tschaikowsky K, Palmaers T, Schmidt J (1999). Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS. Critical Care, 3(1): 45–50. https://doi.org/10.1186/cc306

Pontrelli G, De Crescenzo F, Buzzetti R, Jenkner A, Balduzzi S, Calò Carducci F, et al (2017). Accuracy of serum procalcitonin for the diagnosis of sepsis in neonates and children with systemic inflammatory syndrome: a meta-analysis. BMC Infectious Diseases, 17: 302. https://doi.org/10.1186/s12879-017-2396-7

Samsudin I, Vasikaran SD (2017). Clinical utility and measurement of procalcitonin. Clinical Biochemistry Reviews, 38(2): 59

Schuetz P, Birkhahn R, Sherwin R, Jones A, Singer A, Kline J, et al (2017). Serial procalcitonin predicts mortality in severe sepsis patients: results from the multicenter procalcitonin MOnitoring SEpsis (MOSES) study. Critical Care Medicine, 45(5): 781–9. https://doi.org/10.1097/ccm.0000000000002321

Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al (2016). Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (sepsis-3). Journal of the American Medical Association, 315(8): 762–74. https://doi.org/10.1001/jama.2016.0288

Tuoni C, Ciantelli M, Morganti R, Violi M, Tamagnini S, Filippi L (2022). Procalcitonin levels in preterm newborns: reference ranges during the first three days of life. Frontiers in Pediatrics, 10. https://doi.org/10.3389/fped.2022.925788

Yunus I, Fasih A, Wang Y (2018). The use of procalcitonin in the determination of severity of sepsis, patient outcomes and infection characteristics. PLoS One, 13(11): e0206527. https://doi.org/10.1371/journal.pone.0206527

Downloads

Published

2026-01-06

How to Cite

Procalcitonin as a Biomarker for Predicting Clinical Utility in Cases of Neonatal Sepsis: Outcomes from a Single-Centric Procalcitonin Monitoring Study. (2026). Indian Journal of Public Health Research & Development, 17(1), 253-259. https://doi.org/10.37506/wq9yvx74