Abstract
Background: Neonatal sepsis is a life-threatening condition with high mortality and morbidity throughout the world.
 Objective: This study evaluated the diagnostic role of serum procalcitonin (PCT), interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a) and C-reactive protein (CRP) in the early diagnosis of neonatal sepsis.
 Methods: This cross-sectional study was conducted among neonates admitted to the special baby care unit (SCABU) of BIRDEM General Hospital, Dhaka, from November 2018 to April 2019. According to selection criteria, 90 clinically suspected cases of neonatal sepsis were selected and categorised into confirmed, probable, and no sepsis groups based on CRP, white cell count, platelet count, and blood culture results. Serum PCT, IL-6, and tumor necrosis factor (TNF-a) were estimated in all cases by standard laboratory methods.
 Results: Serum PCT, IL-6, CRP, and TNF-awere significantly higher in confirmed and probable sepsis groups in comparison to no sepsis group. Among the studied biomarkers, serum PCT was found most sensitive (95% sensitivity), and serum IL-6 was found most specific biomarkers (65.7% specificity) than CRP and TNF-a for the diagnosis of neonatal septicaemia. Though the accuracy of both PCT and IL-6 was found equal (70%), but the positive predictive value (PPV) and negative predictive value (NPV) of serum PCT were higher than IL-6.
 Conclusion: Both serum PCT and IL-6 are more sensitive and specific markers than CRP and TNF-a in the diagnosis of neonatal sepsis. Moreover, serum PCT is more useful than IL-6.
 Bangladesh Med Res Counc Bull 2020; 46(2): 83-89
Highlights
Neonatal sepsis (NS) is a major cause of mortality and morbidity in newborn, and it is recognized as a global public health challenge.[1,2] World Health Organization (WHO) estimates that 1 million deaths per year occur due to neonatal sepsis, and 42% of these deaths occur in the first week of life.[3,4] Incidence of NS in south Asia is 4-10 times higher than that of developed countries.[5]
Serum PCT is more useful than IL-6
Cases were classified into 3 groups – confirmed sepsis, probable sepsis, and no sepsis groups.11,13Group-1: Confirmed sepsis (n=20); Group-2: Probable sepsis (n=29) [subjects had ≥ 3 sepsisrelated signs and symptom, blood culture-negative but positive sepsis screen which was defined by the presence of at least 2 altered sepsis-related blood tests including positive C-reactive protein (CRP), leukocytosis or leukopenia, thrombocytopenia, and low absolute neutrophil count;25,26,27]; Group-3: No sepsis (n=41) (≥ 3 sepsis-related signs and symptoms but blood culture-negative and negative sepsis screen defined by the presence of less than 2 altered blood screening parameters)
Summary
Neonatal sepsis (NS) is a major cause of mortality and morbidity in newborn, and it is recognized as a global public health challenge.[1,2] World Health Organization (WHO) estimates that 1 million deaths per year occur due to neonatal sepsis, and 42% of these deaths occur in the first week of life.[3,4] Incidence of NS in south Asia is 4-10 times higher than that of developed countries.[5]. Neonatal sepsis is a life-threatening condition with high mortality and morbidity throughout the world
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