Background: High percentage of intensive care unit (ICU) admissions are due to sepsis. Some evidence suggests procalcitonin (PCT) is a useful sepsis prognostic marker. Acute phase protein, which is called pentraxin3 (PTX3) may help in sepsis screening.
Objective: To assess the prognostic value of the PTX3 and PCT in neonatal sepsis in comparison with other screening markers.
Patients and Methods: A prospective study included 40 neonates with sepsis. The study had been conducted in the neonatal ICUs of Ain Shams University, Children's Hospital during the period from January 2020 to May 2022. All neonates had been subjected to clinical examination, anthropometric measurements and sepsis scoring by neonatal sequential organ failure assessment (nSOFA). Laboratory investigations were performed including complete blood count, blood culture, assay of serum levels of C-reactive protein (CRP), PCT and PTX3.
Results: The CRP levels were significantly lower in the deteriorated group compared to the better group, whereas PCT and PTX3 levels were significantly higher with p-value=0.004, 0.016 and 0.019, respectively. After 3 days, CRP, PCT and PTX3 levels increased significantly in deteriorated group than improved group with p-value=0.002, <0.001 and <0.001, respectively. The combination between baseline nSOFA score, CRP and PCT levels had a sensitivity of 84.62%, specificity of 92.59% and AUC 0.906. While combination between baseline nSOFA CRP and PTX3 levels had the highest sensitivity of 100% and AUC of 0.909 in prediction the poor outcome of the studied patients.
Conclusion: Serum levels PCT and PTX3 seem to be promising prognostic markers in neonatal sepsis.