1370 Service Evaluation of Serum Procalcitonin in Management of Neonatal Sepsis

Background: Infection is a major concern in neonatal population. After reviewing available literature, procalcitonin was introduced in management of neonatal sepsis with other markers of infection, already in use in our neonatal unit. Aim: This service evaluation aims to review the role of procalcitonin in early detection of sepsis and compare it with existing tools. Method: Neonatal sepsis management guideline was reviewed. A new algorithm was introduced. Serum procalcitonin level was checked with regular inflammatory markers in all episodes of suspected sepsis. An enzyme-linked fluorescent assay determined serum procalcitonin level. Cut off value for CRP is 7.5 ml/Land for serum procalcitonin levels were - 2ng/mL at birth, 15 ng/mL at 24 hours and 2ng/mL from 48 hours onwards. Result: This evaluation was performed over one month. 29 episodes of suspected sepsis were evaluated. 20 episodes were of early onset and 9 were of late onset. Procalcitonin was raised in all cases of suspected sepsis where there was clinical concern with raised CRP. 3 infants (10%) had raised procalcitonin level at point of suspicion where the CRP levels were normal, 2 were term infants with significant clinical concerns regarding late onset sepsis. One infant had raised CRP levels at birth and 24 hours although the procalcitonin levels were normal. Conclusion: Procalcitonin was noted to be more sensitive than CRP for early detection of neonatal sepsis, particularly in late onset sepsis in term infants. Further evaluation is needed to determine whether procalcitonin helps to reduce use of antibiotics and helps in cost-effectiveness.