Assessment of C-reactive protein, procalcitonin and interlukin-6 as diagnostic aid for neonatal infections at a tertiary care center

Jayesh Pandey,Dakshina Bisht,Mahima Mittal,Amresh Kumar Singh

doi:10.51248/.v41i4.952

Abstract

Introduction and Aim: Neonatal infections are the leading cause of mortality among neonates after prematurity. The importance determining biological markers to be used as a diagnostic test to detect neonatal infections the in early stage of the disease is a challenge. The purpose of this study was to evaluate the usefulness & sensitivity of various serological markers such as serum Procalcitonin, C-reactive protein and chemokine IL-6 for diagnosis of neonatal infections leading to sepsis in new born infants. Materials and Methods: This cross-sectional study was carried out among newborns admitted in neonatal intensive care unit (NICU) and meeting the selection criteria. Samples were collected for blood culture and ELISA was performed for detection of CRP, PCT & IL-6. Results: A total of 300 newborns were included in this study from NICU of which 132 (44%) neonates was found to be blood culture positive. The most frequently isolated organisms were Klebsiella pneumoniae (26.5%), followed by Candida albicans (18.1%). In case of confirmed neonatal sepsis, significant higher levels of CRP, PCT and IL-6 were detected than in cases of probable sepsis. Serum procalcitonin levels exhibit highest sensitivity and specificity as 65.91% and 91.67% respectively. Conclusion: Serum procalcitonin has better diagnostic utility in terms of biological marker for the diagnosis of neonatal infections than C- reactive protein and Interleukin-6.

Highlights

Introduction and AimNeonatal infections are the leading cause of mortality among neonates after prematurity
Medical College, Gorakhpur, Uttar Pradesh and was conducted on the neonates admitted in the neonatal intensive care unit (NICU) of associated Nehru Hospital of B.R.D
In our study, when analyzing the differences in markers between proven and probable cases of neonatal sepsis, the mean ± SD serum level of procalcitonin was 1236.11 ± 827.37 pg/ml in proven sepsis when compared with mean serum level 392.98 ± 286.16 pg/ml of probable sepsis, and the difference was found to be highly significant (p ≤ 0.001)

Summary

Introduction

Neonatal infections are the leading cause of mortality among neonates after prematurity. The importance determining biological markers to be used as a diagnostic test to detect neonatal infections the in early stage of the disease is a challenge. 2.4 million children die in the first month of their life. A recent data from the year 2019 shows approximately 6,700 neonatal deaths every day with about a third of all neonatal deaths occurring within the first day after birth and close to threequarters occurring within the first week of life. About 0.75 million neonates die every year in India, the highest for any country in the world [1,2]. In India beside prematurity, neonatal infections are the leading cause of mortality among neonates [2]. The traditional diagnostic methods, such as C-reactive protein (CRP) and leukocyte count are not specific enough for differentiating bacterial infections from viral infections and systemic inflammation [3]

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