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Is Procalcitonin and Lactate a Early Markers for Sepsis in Newborns in the ICU

Aspazija Sofijanova, Sonja Bojadzieva, Elizabeta Shuperliska and Olivera Jordanova

Objective: The aim of this study was to evaluate the predictive values of procalcitonin (PCT) and lactate as a early diagnostic marker for sepsis in newborns at the ICU.

Methods: In a prospective study, 100 newborns with proven sepsis were included from period January 2019 year till August 2020 year. Laboratory examination were analyzedin the Clinical Laboratory at the University Children Hospital-Skopje. Sample for blood culture, PCT and blood gas-lactate were taken the first at the admission, the second on 3 day and the third 7 day. Blood culture media were incubated at 37°C for 5days in BactAlert 3D 360. Positive blood culture were proven with the new multiplex polymerase chain reaction–based rapid diagnostic test (BioFire FilmAray Blood Culture Identification). Procalcitonin was determined by immunoassay: patented ELFA (Enzyme-linked fluorescent assay) technology, automated Vidas Biomerieux immunoassay (ng/ml) . Blood gas-lactate were determined with Rapid point 500 Siemens.

Results: In the study we included 100 (M: F=59:41) newborns with proven sepsis hospitalized. We isolated fifty seven newborns who had two or three bacteria at the same time, included Staphylococcus aureus (n=61) mecA, Streptococcus (n=6), Acinetobacter baumannii (n=16), Serratia marcescens (n=8) and Entrobacteriaceae (n=32), Candida albicans (n= 1) Candida parapsilosis (n=1). Statistical analysis confirmed significantly different values of PCT in the analyzed time period in preterm newborns with proven sepsis p<0.001. Statistical analysis confirmed significantly different values of Lactate in the analyzed time period in preterm newborns with proven sepsis p<0.001.

Conclusion: PCT and lactate have prognostic value as biomarkers in patients with sepsis. Together, these two biomarkers provide early detection, information on the severity of sepsis, efficacy in the use of antibiotic therapy, and assessment of outcome in critically ill patients with sepsis.