Procalcitonin Useful Diagnostic Marker for Treatment the Asphyxed Preterm Newborns with Sepsis

Background: Birth Asphyxia can lead to severe hypoxic ischaemic organ damage in newborns followed by neurodegenerative diseases, mental retardation and epilepsies, leading to significant mortality and morbidity in the Intensive Care Unit at the University Children Hospital-Skopje.

Objective: The aim of this study was to determining the corelation between the levels of PCT levels in pretern newborns with asphyxia and term newborns with asphyxia, with sepsis and proven blood culture

Methods: In this study we include the 31 (M:F=14:17) sepsis newborns with asphyxia and proven blood culture. They have been divided into two groups I group included 11 septic preterm newborns with asphyxia and II group - 20 septic term newborns.. Results of WBC, C-reactive protein (CRP) and PCT, were recorded. Procalcitonin levels was assessed before the beginning of the antibiotic treatment and second measurement after 3 days, by using a immunoassay system Vidas based on the Enzyme Linked Fluorescent Assay (ELFA) principles.

Results: We confirmed Staphylococcus , methicillin-resistance gene in all preterm newborns. 14 term newborns were with confirmed Staphylococcus , methicillin-resistance gene and in other 6 term newborns were confirmed Staphylococcus and Streptococcus pneumonia. The values of procalcitonin (PCT) were considerably increased in septic preterm newborns with asphyxia, relative to term newborns. This difference was statistically significant. The values of C-reactive protein gradually increase after 24-36 hours in both groups. The second measurement of PCT after 3 days is a parameter, who show us whether an appropriate antibiotic for the treatment is used and may prevent severe sepsis and septic shock in newborns.

Conclusion: Increased PCT level was significantly associated with preterm newborns with confirmed Staphylococcus , methicillin-resistance gene. The value of PCT is a reliable parameter whether an appropriate antibiotic treatment is used in newborns with asphyxia, and and gram positive blood culture