Diagnostic Utility of Cerebrospinal Fluid Procalcitonin in Neonatal Meningitis

Abstract We aimed to study the diagnostic utility of cerebrospinal fluid (CSF) procalcitonin in neonates with meningitis. All the neonates with sepsis who qualified for lumbar puncture were prospectively evaluated. The neonates were classified as Meningitis and No meningitis group based on predefined criteria. CSF procalcitonin was estimated in these neonates along with cytological and biochemical parameters. A total of 113 neonates were included in the study with 29 in meningitis group and 84 in no meningitis group. The median procalcitonin levels was higher in babies with meningitis as compared to those without meningitis [0.194 (0.034 - 0.534) in meningitis group vs 0.012 (0.012-0.012) ng/ml in no meningitis group, p< 0.001]. The area under curve (AUC) for CSF procalcitonin was 0.867 (0.77 -0.95) and at a cut off level of 0.120 ng/ml CSF procalcitonin had a sensitivity of 83%, specificity of 84% and positive and negative predictive likelihood ratios of 5.35 and 0.20 respectively for the diagnosis of meningitis. Conclusion: CSF procalcitonin has a good diagnostic accuracy similar to other parameters in the diagnosis of neonatal meningitis and can be considered as an additional diagnostic marker particularly, when CSF culture is negative and cytochemical analysis is inconclusive.Trial registration number and date: CTRI/2018/09/015720 ; 14/09/2018