Procalcitonin as a diagnostic tool for bacterial neonatal sepsis

Background Bacterial sepsis is the main cause of morbidity and mortality in neonates. Early diagnosis and appropriate treatment can reduce the mortality rate. Blood culture is the gold standard for diagnosis of bacterial sepsis, but it requires 3-5 days for results. Since the disease may progress rapidly in neonates, a faster diagnostic test is needed. Measurement of procalcitonin levels may be a quick method to diagnose bacterial sepsis in neonates. Some studies found the sensitivity of procalcitonin to be between 92-100%. Objective To assess the use of procalcitonin as an early diagnostic tool for bacterial neonatal sepsis. Methods This diagnostic study was conducted from October 2011 to February 2012. Forty-three neonates in the Perinatology Unit at H. Adam Malik Hospital were suspected to have bacterial sepsis. They underwent routine blood counts, blood cultures, as well as C-reactive protein and procalcitonin measurements. Subjects were collected by consecutive sampling. The gold standard of sepsis was based on any microorganism found in blood culture. Results Of 43 neonates, 36 neonates had bacterial sepsis. We found that procalcitonin sensitivity was 100%, specificity 85.71%, positive predictive value 97.29% and negative predictive value 100%. The ROC curve showed a cut-off point of 0.929 (95%CI 0.713 to 0.953). Conclusion Procalcitonin is useful as an early diagnostic tool for bacterial neonatal sepsis.

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Hematological scoring system as an early diagnostic tool for neonatal sepsis

Paediatrica Indonesiana ◽

10.14238/pi55.6.2015.315-21 ◽

2016 ◽

Vol 55 (6) ◽

pp. 315

Author(s):

Fathia Meirina ◽

Bidasari Lubis ◽

Tiangsa Sembiring ◽

Nelly Rosdiana ◽

Olga Siregar

Keyword(s):

Platelet Count ◽

Blood Culture ◽

Diagnostic Tool ◽

Neonatal Sepsis ◽

Scoring System ◽

Leucocyte Count ◽

Degenerative Changes ◽

Total Leucocyte Count ◽

Diagnostic Study ◽

Early Diagnostic

Background Sepsis was the leading cause of death in babies by30%-50% in developing countries. Early diagnosis of neonatalsepsis is still a difficult problem because of clinical features are notspecific. Blood culture is the gold standard, but it takes several daysand is expensive. The hematological scoring system (HSS) consistsof hematologic parameters (leucocyte count, polymorphonuclear(PMN) cells, degenerative changes, and platelet count) for earlydiagnosis of neonatal sepsis.Objective To measure HSS as an early diagnostic tool for neonatalsepsis.Methods A cross sectional study was conducted in March toJune 2013. Samples were collected by consecutive sampling.Fourty neonates suspected sepsis in neonatology unit H. AdamMalik Hospital, Medan, North Sumatera, underwent routineblood count, blood culture, and peripheral blood smear. Eachhematologic parameters were analysed using the HSS of Rodwellet al. The hematologic parameters were total leucocyte count, totalPMN cells, total PMN immature, I:T PMN ratio, I:M PMN ratio,degenerative changes, and platelet count. The total value revealedHSS score. Diagnostic study parameters were calculated.Results Ten of fourty neonates had sepsis based on blood culture􀁕􀁈􀁖􀁘􀁏􀁗􀁖􀀑􀀃􀀷􀁋􀁈􀀃􀀫􀀶􀀶􀀃􀁖􀁆􀁒􀁕􀁈􀀃􀂕􀀗􀀃􀁋􀁄􀁇􀀃􀁖􀁈􀁑􀁖􀁌􀁗􀁌􀁙􀁌􀁗􀁜􀀃􀀛􀀓􀀈􀀏􀀃􀁖􀁓􀁈􀁆􀁌􀁉􀁌􀁆􀁌􀁗􀁜􀀃􀀜􀀓􀀈􀀏􀀃with positive predictive value (PPV) 73%, negative predictivevalue (NPV) 93%, ROC curve showed cut off point 0.902 (95%CI 0.803 to 1.0).Conclusion 􀀶􀁆􀁒􀁕􀁈􀀃􀀫􀀶􀀶􀀃􀂕􀀗􀀃􀁆􀁒􀁘􀁏􀁇􀀃􀁅􀁈􀀃􀁘􀁖􀁈􀁇􀀃􀁄􀁖􀀃􀁄􀁑􀀃􀁈􀁄􀁕􀁏􀁜􀀃􀁇􀁌􀁄􀁊􀁑􀁒􀁖􀁗􀁌􀁆􀀃tool for neonatal sepsis.

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Immature-to-total neutrophil ratio as an early diagnostic tool of bacterial neonatal sepsis

Paediatrica Indonesiana ◽

10.14238/pi55.3.2015.153-7 ◽

2015 ◽

Vol 55 (3) ◽

pp. 153 ◽

Cited By ~ 3

Author(s):

Darnifayanti Darnifayanti ◽

Guslihan Dasa Tjipta ◽

Rusdidjas Rusdidjas ◽

Bugis Mardina Lubis

Keyword(s):

Diagnostic Tool ◽

Peripheral Blood ◽

Neonatal Sepsis ◽

Predictive Value ◽

Characteristic Curve ◽

Blood Cultures ◽

Bacterial Sepsis ◽

Blood Smears ◽

Peripheral Blood Smears ◽

Early Diagnostic

Background Bacterial sepsis is the main cause of morbidity and mortality in neonates. Early diagnosis and appropriate treatment for the condition can reduce mortality rates. Blood cultures are the gold standard to diagnose bacterial sepsis, but they require 3-5 days for results, whilst the disease may progress rapidly in neonates. Examination of immature-to-total neutrophil ratio (I/T ratio) in peripheral blood smears is a quicker and less expensive method to diagnose bacterial sepsis in neonates. Some studies found the sensitivity of I/T ratio to be 88%-90% in predicting bacterial spesis.Objective To assess the usefulness of the I/T ratio as an early diagnostic tool for neonatal bacterial sepsis.Methods This cross-sectional study was conducted from February to March 2011. Subjects were collected by consecutive sampling. Fifty-three neonates suspected to have bacterial sepsis in the Perinatology Unit at H. Adam Malik Hospital were included. Subjects underwent routine blood examinations, C-reactive protein level measurements, blood cultures, and peripheral blood smears. All statistical analyses were conducted with SPSS (version 16.0 for Windows).Results Of the 53 subjects, 26 had bacterial sepsis based on blood cultures. The I/T ratio had a sensitivity of 88.46%, specificity 81.84%, positive predictive value 82.14%, and negative predictive value 88%. The receiver operating characteristic curve showed a cut-off point of 83.3 (95%CI 71.3 to 95.3)%.Conclusion The I/T ratio may be a good alternative to blood cultures as an early indicator of bacterial neonatal sepsis, as it is faster, less expensive and has good sensitivity and specificity.

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TLR2 and TLR4 expressions in late-onset neonatal sepsis: Is it a potential novel biomarker?

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-200411 ◽

2020 ◽

pp. 1-7

Author(s):

R. Rohsiswatmo ◽

M. Azharry ◽

T.T. Sari ◽

Y. Bahasoan ◽

D. Wulandari

Keyword(s):

Blood Culture ◽

Neonatal Sepsis ◽

Predictive Value ◽

Complete Blood Count ◽

Late Onset ◽

Diagnostic Value ◽

Cross Sectional Study ◽

Tlr4 Expression ◽

Cross Sectional ◽

Reactive Protein

BACKGROUND: Late-onset neonatal sepsis (LONS) detection is problematic as no single examinations (blood culture, c-reactive protein (CRP), procalcitonin (PCT)) are reliable. Toll-like receptors (TLRs), which detect the presence of pathogen-associated molecular patterns is a promising novel biomarker, but less studied in LONS. This study aimed to determine neutrophils and monocytes TLR2 and TLR4 expression in LONS and their diagnostic value. METHODS: A cross-sectional study conducted in May and June 2017 involving 52 neonates with clinical late-onset (>72 hours of age) sepsis. We examine complete blood count, I/T ratio, CRP, PCT, as well as TLR2 and TLR4 expression to compared with blood culture as the gold standard. We classified cases into proven or unproven sepsis. RESULT: The incidence of LONS was 32.6% in the subjects. The expression of TLR2 was low in LONS, while TLR4 was high. TLR4 neutrophil expression has 88.2% sensitivity, 20% specificity, 34.9% positive predictive value (PPV), 77.8% negative predictive value (NPV), and an AUC of 0.541. TLR4 monocyte expression has 92.1% sensitivity, 11.4% specificity, 34% PPV, 80% NPV, and an AUC of 0.528. The AUC of CRP is increased from 0.608 to 0.843 after combination with TLR4, comparable with CRP + PCT (AUC 0.829). CONCLUSION: The increase in TLR4 expression has good sensitivity but low specificity. TLR4 expression, in combination with CRP, could become a reliable biomarker for the diagnosis of LONS.

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Diagnostic Utility of C-Reactive Protein and Permutation Combination of Quantitative and Qualitative Haematological Parameters in Neonatal Sepsis

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/50366.15483 ◽

2021 ◽

Author(s):

Sapna Shreyas Deshpande ◽

Mohasin Jakirhusain Halgale ◽

Ravindra Vilas Ramteke

Keyword(s):

Blood Culture ◽

Peripheral Blood ◽

Neonatal Sepsis ◽

Predictive Value ◽

Blood Smear ◽

Peripheral Blood Smear ◽

Haematological Parameters ◽

Diagnostic Utility ◽

C Reactive Protein ◽

Reactive Protein

Introduction: Neonatal sepsis at times is subclinical and lacks specific symptoms. The C-Reactive Protein (CRP) which is an acute phase reactant protein is thought to be an alternative biomarker to blood culture. Haematological parameters of sepsis are indirect biomarkers of infection. Authors found it worthwhile to discern efficacy of haematological parameters obtained by such three part haematology analysers in diagnosis of neonatal sepsis, when used in their pure form or with peripheral blood smear or with CRP, in isolation or in their combinations. Aim: To find out the diagnostic utility of combinations of haematological parameters as obtained by three part differential automated haematology analyser and peripheral blood smear along with CRP in neonatal sepsis. Materials and Methods: This observational and analytical study of diagnostic test outcome was carried out over a period of 12 months from January-December 2016 in Rajarshi Chhatrapati Shahu Maharaj Medical College and Chhatrapati Pramilaraje Rugnalaya, Kolhapur, Maharashtra, India, with special reference to clinical profile, blood culture, qualitative and quantitative haematological parameters and CRP. The statistical analysis included calculating diagnostic utility of isolated and combination of parameters and performing Chi-square test to study difference in frequency of occurrence and significance of association. Results: There were 104 cases of neonatal sepsis out of which culture proven sepsis was seen in 73 (70.2%) cases while probable sepsis was seen in 31 (29.8%) cases. There were 32 (30.8%) fatalities. With parallel method with OR values, combination of haemoglobin, platelet parameters and White Blood Cells (WBC) parameters as obtained by analyser and peripheral blood smear exhibited sensitivity of 98.6%, specificity and Positive Predictive Value (PPV) of 100%, Negative Predictive Value (NPV) of 96.9% and Diagnostic Accuracy (DA) of 99%. This was surpassed by combination of CRP and all these parameters to attend values of 100%. Combination of all haematological parameters obtained purely by analyser showed these values to be 89%, 100%, 79.5% and 92.3%. Immature to Total WBC (I:T) ratio and platelet count influenced clinical outcome of fatality. Conclusion: The liberal use of combination of haematological parameters is rewarding in supporting diagnosis of neonatal sepsis. The same was obtained by purely using analyser which showed remarkable diagnostic utility suitable for resource poor settings.

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PROKALSITONIN, CRP DAN PRESEPSIN SERUM DI SIRS

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v20i3.475 ◽

2016 ◽

Vol 20 (3) ◽

pp. 183

Author(s):

Hendrianingtyas Hendrianingtyas ◽

Banundari RH ◽

Indranila KS ◽

Imam Budiwiyono

Keyword(s):

Blood Culture ◽

Predictive Value ◽

Gold Standard ◽

Clinical Signs ◽

Diagnostic Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Risk Of Death ◽

Higher Sensitivity ◽

Septic Condition

Infection in ICU patients can lead to a septic condition with clinical signs similar to Systemic Inflammatory Response Syndrome (SIRS). The high risk of death and high cost of sepsis is the reason to find an early marker in diagnosing sepsis. Blood culture can givea result in 1-3 days, so C reactive protein, procalcitonin and presepsin which are fast and accurate are needed to find a septic condition in SIRS patients. The aim of this study is to determine the diagnostic value of CRP, PCT and presepsin of sepsis with blood culture as the gold standard., The samples were collected from 32 clinically SIRS patients in the Dr. Kariadi Hosiptal, Semarang. The PCT level was measured using ELFA method, CRP level by PET IA method, while presepsin level by CLEA method. The determined area was under curve (AUC) and the cut off level was determined by 2×2 table to find out the sensitivity, spesificity, positive predictive value, negative predictive value and likelihood ratio of CRP, PCT and presepsin as well. The AUC of PCT, CRP and presepsin was 0.78 (cut off 4.314 ng/mL); 0.673 (cut off 10.245 mg/L) and 0.814 (cut off 1134.5 pg/mL). The presepsin level had a higher sensitivity (90%) than PCT (80%) and CRP (70%). PCT specificity was 72.73%, presepsin and CRP specificity each was 68.18%. Based on this study, AUC and sensitivity of presepsin level were found higher than the PCT and CRP level.

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Diagnostic Value of Immature-to-Total Neutrophil Ratio in Neonatal Sepsis

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v8i4.475 ◽

2019 ◽

Vol 8 (4) ◽

pp. 166-170

Author(s):

Husnain Ali ◽

Ejaz Hussain ◽

Imran Mahmood Khan ◽

Iqtada Haider Shirazi ◽

Muhammad Imran ◽

...

Keyword(s):

Blood Culture ◽

Diagnostic Accuracy ◽

Neonatal Sepsis ◽

Predictive Value ◽

Gold Standard ◽

Diagnostic Value ◽

Standard Test ◽

Negative Blood Culture ◽

Gold Standard Test ◽

Sensitivity Specificity

Background: Neonatal sepsis is the third most common reason of neonatal mortality in Pakistan. Blood culture, the gold standard test for diagnosis of neonatal sepsis, is time consuming. Therefore, rapid diagnostic tests with good specificity and sensitivity is needed for accurate and early diagnosis of this condition. The objective of this study was to determine the diagnostic value of abnormal (≥ 0.2) immature-to-total-neutrophil ratio in neonatal sepsis.Material and Methods: This cross-sectional study was carried out on 288 neonates, aged 0-28 days, admitted with suspected sepsis. Detailed history of the neonates was recorded including gender, age, birth weight, maternal age, gestational age and clinical features. Blood culture and Peripheral blood films were done in each case. Differential leucocyte counts, total Polymorphoneutrophil count (PMN), immature neutrophil count, mature neutrophil count and calculation of I/T ratio was carried out in the Pathology Department of PIMS, Islamabad. The study outcome was divided into three groups on the basis of positive or negative blood culture and I/T ratio as normal, probable sepsis and proven sepsis group. Data was analyzed by SPSS version 21.0. Diagnostic value of I/T ratio was determined in NS by calculating values of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) by considering the blood culture as the gold standard test of NS.Results: The mean age and weight of the neonates at the time of admission was 1.1 (± 0.6) days and 2.51 (± 0.40) kg, respectively. About 60% of the neonates were males and 118(41%) neonates had I/T ratio of ≥ 0.2. On the basis of positive or negative blood culture and I/T ratio, 82 (28.5%) neonates were diagnosed as proven sepsis, 43 (14.9%) neonates had probable sepsis and remaining 163 (56.6%) neonates were declared as normal. Out of 82 neonates with positive blood cultures, 75 (91.5%) had I/T ratio ≥ 0.2, while 7 (8.5%) had I/T ratio ≤ 0.2. The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of abnormal I/T ratio to diagnose neonatal sepsis was 91%, 79%, 64%, 96% and 83%, respectively.Conclusions: Due to substantially high diagnostic accuracy of I/T ratio ≥ 0.2, we recommend it as a useful, rapid and cost-effective tool in accurate diagnosis of neonatal sepsis.

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Diagnostic accuracy of septic markers for neonatal sepsis

Paediatrica Indonesiana ◽

10.14238/pi48.5.2008.299-305 ◽

2016 ◽

Vol 48 (5) ◽

pp. 299

Author(s):

Thermiany AS ◽

W Retayasa ◽

M Kardana ◽

IN Lila

Keyword(s):

Blood Culture ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Likelihood Ratio ◽

Neonatal Sepsis ◽

Predictive Value ◽

Gold Standard ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Suspected Sepsis

Background Neonatal sepsis is a major cause of morbidity andmortality. A positive blood culture is the gold standard fordiagnosis of neonatal sepsis. The signs and symptoms suggestingneonatal sepsis are non-specific. There is no rapid and reliablelaboratory test findings for confirmation of etiologic diagnosis.Clinical signs, symptoms, and laboratory examinations are notperceived as sensitive or specific for diagnosis of sepsis.Objective The purpose of this study was to evaluate the accuracyof the septic markers for diagnosis of neonatal sepsis.Methods Blood culture was used as gold standard to compareseptic markers to diagnose neonatal sepsis. Sensitivity, specificity,positive predictive value (PPV), negative predictive value (NPV),positive and negative likelihood ratio (LR), and accuracy werecalculated.Results We identified 130 cases suspected of neonatal sepsis duringSeptember 2005 until March 2006. Four patients were excludedbecause of major congenital anomalies. The mean age was 2.2 daysand 51.6% were boys. We found fifty six (44.4%) neonates havepositive blood culture. All of septic markers had sensitivity morethan 80%. Immature to Total Neutrophil ratio (Iff) ratio had thehighest sensitivity (96.4%) and C-Reactive Protein (CRP) had thelowest sensitivity (80.4o/o). Combination among leukocyte count,thrombocyte, and Iff ratio had the highest sensitivity (sensitivitywas 85. 7%, specificity was 97.1 o/o, positive predictive value was95.9%, negative predictive value was 89.5%, accuracy was 94.4%,and positive likelihood ratio was 30.0).Conclusion Septic markers can be used in the diagnosticevaluation of neonates with suspected sepsis.

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A hematologic scoring system and C-reactive protein compared to blood cultures for diagnosing bacterial neonatal sepsis

Paediatrica Indonesiana ◽

10.14238/pi57.2.2017.70-5 ◽

2017 ◽

Vol 57 (2) ◽

pp. 70

Author(s):

Deddy Eka Febri Liestiadi ◽

Emil Azlin ◽

Selvi Nafianti

Keyword(s):

Blood Culture ◽

Likelihood Ratio ◽

Neonatal Sepsis ◽

Predictive Value ◽

Scoring System ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Blood Cultures ◽

C Reactive Protein ◽

Reactive Protein

Background Neonatal sepsis is the leading cause of death after pneumonia. Definitive bacterial sepsis diagnoses are made by blood culture results, which require a lengthy time. C-reactive protein (CRP) levels and a hematologic scoring system by Rodwell et al. are rapid tests that may be useful for diagnosing neonatal sepsis. Objective To determine the diagnostic value of CRP measurement and a hematologic scoring system compared to blood culture as the gold standard for diagnosing neonatal sepsis. Methods A cross-sectional study was conducted from April to August 2015 in the Neonatology Ward of Haji Adam Malik Hospital, Medan. A total of 43 neonates who were clinically suspected to have sepsis underwent CRP, hematologic scoring, and blood cultures. The IT ratio and procalcitonin indices were also examined. Diagnostic values were analyzed by a 2x2 table.Results Fourteen percent from all sample had positive bacterial culture. The CRP measurements had a sensitivity of 92.8%, specificity of 62%, positive predictive value (PPV) of 54.1%, negative predictive value (NPV) of 94.7%, positive likelihood ratio (PLR) of 2.44, and negative likelihood ratio (NLR) of 0.11. The hematologic scoring system had a sensitivity of 100%, specificity of 82.7%, PPV of 73.6%, NPV of 100%, PLR of 5.78, and NLR of 0. Procalcitonin and IT ratio show a good value of sensitivity and NPV, respectively. Conclusion The hematologic scoring system has better specificity than CRP measurement as compared to blood culture. However, both tests have good sensitivity for diagnosing neonatal sepsis.

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Value of Triggering Receptor Expressed on Myeloid Cells-1 (TREM-1) as a Diagnostic Marker for Neonatal Sepsis

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/46634.14472 ◽

2021 ◽

Author(s):

Mabrouk Mahmoud Ghonaim ◽

Amal Fathalla Makled ◽

Alshimaa Elsayed Youssef ◽

Asmaa Mohammed El-Brolosy

Keyword(s):

Gene Expression ◽

Risk Factors ◽

Blood Culture ◽

Neonatal Sepsis ◽

Predictive Value ◽

Diagnostic Marker ◽

Expression Level ◽

Control Group ◽

Prognostic Utility ◽

Early Diagnostic

Introduction: Neonatal Sepsis (NS) is a serious clinical condition caused by a dysregulated immune response to an infection. Neonatal period is the most vulnerable time in the child’s life. Globally, approximately 7000 newborns die everyday. Triggering Receptor Expressed on Myeloid cells-1 (TREM-1) is an important receptor for the inflammatory response regulated by neutrophils. Aim: To explore the role of TREM-1 as a potential early diagnostic marker of NS compared to the conventional blood culture technique. The prognostic utility and relation of TREM-1 expression level to the clinical disease severity in septic neonates were also evaluated. Materials and Methods: The study enrolled 75 neonates with NS admitted to the Neonatal Intensive Care Unit (NICU). The studied neonates were categorised into three groups; group I: 25 neonates with an Early Onset Sepsis (EOS), group II: 25 neonates with a Late Onset Sepsis (LOS), group III: 25 neonates with septic shock. In addition, 25 age and sex-matched healthy neonates with no evidence of sepsis or any other medical illness were studied as a control group. Blood samples for conventional blood cultures and estimation of TREM-1 gene expression level in Polymorph Nuclear Neutrophils (PMNs) using quantitative Real-Time Polymerase Chain Reaction (RT-PCR) assay were synchronously collected. Data regarding clinical and laboratory findings, and risk factors of NS were also analysed. Statistical Package for the Social Sciences (SPSS) software version 20 was used to analyse the data obtained from the study. Results: The total culture-proven cases represented 24% (18/75) of all the studied neonates with NS. Klebsiella spp. was the most frequently isolated Gram-negative bacteria (4/18; 22.2%) followed by Pseudomonas spp. (3/18; 16.7%) and Acinetobacter spp. (1/18; 5.5%). Coagulase- Negative Staphylococci (CoNs), S. aureus and Candida spp. accounted for 22.2% (4/18), 16.7% (3/18) and 16.7% (3/18) of the isolated organisms respectively. No statistically significant difference was detected between the three studied groups as regards blood culture results. Significant statistical differences were detected between groups I, II and III in relation to the control group (p=0.048, p=0.049 and p<0.001) regarding TREM-1 mRNA expression level. Low Birth Weight (LBW) and prematurity were the most significant risk factors for NS. At a cut-off point of ≥0.631 TREM-1 mRNA could be considered as a potential marker for diagnosis of NS with sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of 65.33%, 96.0%, 98.0% and 48.0%, respectively. The prognostic utility of TREM-1 gene expression proved a sensitivity of 87.8% at a cut-off point >0.369. Conclusion: TREM-1 gene expression has a potential value in prognostic assessment of NS and could be considered as an early diagnostic marker.

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VALIDITY OF C- REACTIVE PROTEIN IN DIAGNOSIS OF NEONATAL SEPSIS.

10.36106/ijsr/1506241 ◽

2020 ◽

pp. 1-4

Author(s):

Ghongade P. G. ◽

Khaire P. B.

Keyword(s):

Birth Weight ◽

Neonatal Sepsis ◽

Predictive Value ◽

Screening Test ◽

Treatment Strategies ◽

High Sensitivity ◽

C Reactive Protein ◽

Suspected Sepsis ◽

Adequate Treatment ◽

Reactive Protein

Background: Neonatal sepsis with its high incidence &grave prognosis, in spite of adequate treatment with modern antibiotics, has been a challenge for all times. Optimal diagnosis and treatment strategies are difficult to define. It is essential to diagnose early with laboratory investigation like serial CRP; so that a feasible, rapid and a relatively economic method to diagnose neonatal sepsis at earliest can be instituted even at basic health care level. hence a study was planned to find out the role of CRP against blood culture in early detection of neonatal sepsis. Aim & Objective: To evaluate Validity of C-Reactive Protein as a screening test in neonatal sepsis. Material and Method: This prospective study was carried out inpaediatric dept of medical college. 100 neonates (≤ 28 days) with suspected neonatal sepsis having a birth weight of ≥ 1000 grams admitted during a period from January 2020 to March 2020 were screened primarily with C-Reactive Protein. Serial level of CRPon the day of admission,2nd ,4th ,6th ,8th& 10th day was compared with the serial blood cultureon the day of admission,8th,15th& 21st day to establish the validity of CRP as a screening test.Data analysis carried out by Percentages, Chi Square test, Sensitivity, Specificity, Positive predictive value, Negative predictive value. Results: Amongst 100neonate 76% were early neonates,65% were low birth weight,CRP was having high sensitivity & specificity(78.57%,76.74% respectively). ROC analysis showed AUC 0.8 with p<0.001.Conclusion: CRP is a good screening test & establishes its validity in diagnosing suspected sepsis.

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