Role of procalcitonin and TNF ? as a marker for early detection of neonatal sepsis in Taif, Saudi Arabia

Objectives: A rapid test with the best degree of diagnostic efficiency is required for the early diagnosis and treatment of neonatal sepsis. So this study aimed to evaluate serum procalcitonin (PCT) and TNF? as a diagnostic marker of neonatal sepsis, and comparetheir diagnostic efficiency with C-reactive protein (CRP). Design and methods: 240 neonates were included and classified into three groups. The patients groups were: Proven septic, suspected septic and control healthy neonates, classified depending on Tollner score.CRP,TNF? and PCT values were analyzed, compared, and their effectiveness as diagnostic markers was determined by using receiver operating characteristic (ROC) curve analysis. Sensitivity, specificity, positive, and negative predictive values of the markerswere also calculated. Results: significant elevation was detected in serum levels of CRP, PCT and TNF? in both suspected and proved groups when compared with the control group. Also, higher specificity and sensitivity values were detected for PCT and TNF? (PCT: 90%,67& TNF?: 90%, 63 respectively) in comparison with CRP sensitivity of 70% and specificity of 60%. The positive and negative predictive values were higher for PCT followed by TNF? then that for CRP. Conclusion: PCT and TNF? are the best markers in the diagnosis of neonatal sepsis, and these markers are also could be valuable in following the effectiveness of treatment and determining the prognosis of the disease. The experiments results need to be further studied and the clinical validation is also needed in different region.