C-reactive protein as a diagnostic marker of neonatal sepsis in association with blood culture a retrospective study at a tertiary care hospital

Abstract

To evaluate the sensitivity and specificity of C-Reactive protein as a single diagnostic inflammatory biomarker of neonatal sepsis in association with the blood culture.In this study, we retrospectively reviewed the medical records of 330 neonates at a tertiary care hospital at Gurugram from Jan, 2015 to Dec, 2020. The study population included neonates <1month age. Neonates meeting the IPSC criteria (Sepsis 2.0)1 and with a positive culture were considered as neonates with proven sepsis. Neonates with congenital malformations and congenital infections associated with TORCH complex were excluded from the study.Of the 330 neonates screened for sepsis, 32 (10%) had a positive blood culture with raised CRP in 69 (21%) cases. Among the 32 cases with positive blood culture, CRP identified 29 cases. The sensitivity, specificity, positive predictive value, negative predictive values of CRP were 90.6%, 86.5%, 42% and 99% respectively. The area under the curve (AUC) for the CRP ROC analysis was 0.83 with sensitivity of 90.6% and specificity of 91.6% which showed CRP usefulness as the diagnostic inflammatory biomarker of neonatal sepsis.Prematurity (53%) in neonates was the most common risk factor associated with neonatal sepsis. Klebsiella pneumoniae 11 (34%) was the most common pathogen isolated with 73% susceptibility to Ciprofloxacin.C-Reactive protein was found to have a high diagnostic value in terms of sensitivity of 90.6% and specificity of 91.6% when 0.83 is used as a cut off point for diagnosis of neonatal sepsis. Therefore, CRP could be used as diagnostic inflammatory biomarker in resource poor settings.