C-Reactive Protein : An Important Diagnostic Tool in Neonatal Sepsis
Keywords:
C-reactive protein, Neonatal sepsis, Blood culture
Abstract
Background: Global burden of pediatric mortality during the very first month of life is around four million per year. In developing country like India, neonatal mortality is as high as one fourth (25%) of the global burden means around one million per year. Among the various common causes, infection or sepsis alone contributes for almost 30-40% of total neonatal deaths. The study is aimed to determine the effectiveness of C-reactive protein (CRP) as a diagnostic tool in neonatal sepsis. Materials and Methods: This is a cohort prospective study. Study included total 123 patients considering inclusion and exclusion criteria. Blood samples were taken from all the patients for blood culture and CRP measurements. Results of blood culture and CRP were recorded and statistical analysis was performed by GraphPad Instat Demo. Results: Out of 123 patients included in the study blood culture was positive in 71 (57.72%) patients and CRP was raised in 72 (58.54%) patients. Sensitivity, specificity, positive predictive value and negative predictive value for CRP were found to be 98.59%, 96.15%, 97.23% and 98.04% respectively. Conclusion: C-reactive protein has high sensitivity and specificity with good positive predictive value and negative predictive value for establishing diagnosis of neonatal sepsis and results with CRP are comparable to those with blood culture.References
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2. Upadhyay RP, Chinnakali P, Odukoya O, Yadav K, Sinha S, Rizwan SA, et al. High Neonatal Mortality Rates in Rural India: What Options to Explore? ISRN Paediatrics Volume 2012, Article ID 968921..
3. Lahariya C, Paul VK. Burden, differentials and causes of child deaths in India. Indian J Pediatr, 2010, 77(11), 1312-1321.
4. Edmond K, Zaidi A . New approaches to preventing, diagnosing and treating neonatal
sepsis. PLoS Med, 2010;7, 10.
5. Stoll BJ. Infections of the neonatal infant. In: Kliegman RM, Behrman RE, Jenson HB,
Stanton BF. Nelson text book of paediatrics. Philadelphia: WB Saunders Company, 2008;794-811.
6. Kayange N, Kamugisha E, Mwizamholya DL, Jeremiah S, Mshana SE (2010). Predictors of
positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary
hospital, Mwanza-Tanzania. BMC Pediatr, 10, 39.
7. Arnon S, Litmanovitz I. Diagnostic tests in neonatal sepsis. Curr Opin Infect Dis, 2008;21,
223-37.
8. Kyr M, Fedora M, Elbl L, Kugan N, Michalek J. Modeling effect of the septic condition and
trauma on C-reactive protein levels in children with sepsis: a retrospective study. Crit Care, 2007;11, 70.
9. Benitz WE, Han MY, Madan A, Ramachandra P. Serial serum C-reactive protein levels
in the diagnosis of neonatal infection. Pediatrics, 1998;102(4), E41.
10. Ucar B, Yildiz B, Aksit MA, Yarar C, Colak O, Akbay Y. Serum Amyloid A,
Procalcitonin, Tumor Necrosis Factor-α and Interleukin-1β Levels in Neonatal Late Onset Sepsis.
Mediators Inflamm, 2008;45, 1-7.
11. Couto RC, Barbosa JA, Pedrosa TM, Biscione FM. C-reactive protein guided approach
may shorten length of antimicrobial treatment of culture proven late onset sepsis: An intervention
study. Braz J Infect Dis, 2008;11, 240-5.
12. Payne NR, Burke BA, Day DL. Correlation of clinical and pathologic findings in early
onset neonatal group B streptococcal infection with disease severity and prediction of outcome.
Pediatr Infect Dis, 1998;7, 836.
13. Ferreira RC, Rosane R, Melloa, Kátia S, Silva. Neonatal sepsis as a risk factor for
neurodevelopmental changes in preterm infants with very low birth weight. J Pediatr (Rio J). 2014
14. Arnon S, Litmanovitz I. Diagnostic tests in neonatal sepsis. Curr Opin Infect Dis, 2008;21, 223.
15. Maniaci V, Dauber A, Weiss S. Procalcitonin in young febrile infants for the detection
of serious bacterial infections. Pediatrics, 2008;122, 701.
Published
2018-11-24
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