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Abstract
Objective: This study aimed to assess the diagnostic performance of serum procalcitonin (PCT) and interleukin-6 (IL-6) for the early detection of neonatal sepsis, using blood culture as the reference standard.
Study Design: Cross-sectional validation study.
Place & Duration of Study: Department of Pediatrics, Shaikh Zayed Hospital, Lahore, from November 10, 2023 to May 10, 2024.
Methods: A total of 200 neonates aged 1–7 days admitted with clinical suspicion of early neonatal sepsis were included through consecutive sampling. Blood samples were drawn for PCT, IL-6, and culture. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of both markers were determined against blood culture results.
Results: Of the 200 enrolled infants, 118 (59%) were male and 82 (41%) female, with a mean age of 3.2 ± 1.7 days. Blood cultures grew pathogens in 58 cases (29%). A PCT cut-off of ≥0.23 ng/mL was positive in 64 neonates, yielding a sensitivity of 82.7%, specificity of 87.3%, PPV of 75.0%, NPV of 91.3%, and diagnostic accuracy of 85.5%. For IL-6, a cut-off value of ≥74.85 pg/mL was positive in 71 neonates, showing sensitivity 75.8%, specificity 80.9%, PPV 62.0%, NPV 89.5%, and accuracy 79.0%. ROC analysis demonstrated an AUC of 0.90 (95% CI: 0.84–0.96) for PCT and 0.85 (95% CI: 0.78–0.92) for IL-6.
Conclusion: Both PCT and IL-6 are valuable biomarkers for the early identification of neonatal sepsis, with PCT showing slightly better diagnostic accuracy. These findings support the potential use of PCT as part of clinical decision-making algorithms in local practice.