Usefulness of Cerebrospinal fluid Procalcitonin in Diagnosis of Neonatal Meningitis

Background: To evaluate the diagnostic utility of Cerebrospinal fluid (CSF) Procalcitonin in the diagnosis of neonatal meningitis. Study Design: Prospective Observational Study. Methods: We included 43 neonates with sepsis and suspected meningitis as study subjects. These neonates were categorized into meningitis and non-meningitis groups based on CSF cytology and biochemical parameters. Results: Among the subjects, 22 neonates were categorized into the meningitis group and 21 neonates were in the non-meningitis group, based on Cerebrospinal fluid cytology and biochemical parameters. The mean CSF Procalcitonin values were 0.48 ± 0.37 ng/ml and 0.20 ± 0.08 ng/ml in the meningitis and non-meningitis groups, respectively. A CSF Procalcitonin cut-off value of 0.13 ng/ml demonstrated a sensitivity of 86.36% and a specificity of 23.81% in diagnosing neonatal meningitis. This cut-off value also yielded a positive predictive value of 54.29% and a negative predictive value of 62.50%, with an area under the curve of 0.789 (0.645-0.933). Conclusion: CSF Procalcitonin serves as a reliable biomarker. CSF procalcitonin levels can be utilized as an additional diagnostic marker alongside traditional markers such as CSF protein, sugar, cell count, and culture, particularly when CSF culture results are negative, lumbar puncture is traumatic, or the biochemical and cytological analysis of CSF is inconclusive.