Abstract
Introduction:Nowadays various biochemical markers, such as C-Reactive Protein (CRP), Procalcitonin and tumor necrosis factor alpha, have been proposed as a potential marker for screening neonatal sepsis. In the current study, we tried to see the diagnostic significance of White Blood Cell (WBC) count and CRP in diagnostic screening of neonatal sepsis.Methods:A prospective cross-sectional study was conducted from May 2016 to April 2017 in Asella Teaching and Referral Hospital. Data were entered into EPI-INFO version 3.5.1 for cleanup and then exported to SPSS version 17 for further analysis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were used to assess the accuracy of CRP and WBC count taking blood culture as gold standard.Results:Data of 303 neonates with clinical sepsis were analyzed. Positive CRP and abnormal WBC were reported in 136(45%) and 99(32.7%) of study subjects respectively. Blood culture turned to be positive in 88(29.4%) of study subjects. The Sensitivity, Specificity, PPV and NPV of WBC count were 59.5 %, 79.6%, 52%, 64.5% respectively while the sensitivity, specificity, PPV and NPV of CRP were 65.6%, 78%, 42% and 91% respectively. By combining both WBC and CRP, the sensitivity, specificity, PPV and NPV improve to 78.5%, 83%, 60% and 93% respectively. CRP positivity rate was comparable across gram positive and gram negative bacteria while high WBC count were more reported among gram positive sepsis than gram negative ( OR 4.8, (95% CI 1.45-15.87, P 0.01)Conclusion:Based on this study’s finding, it can be concluded that CRP alone or in combination with WBC count showed better diagnostic accuracy in neonatal sepsis.
Highlights
Nowadays various biochemical markers, such as C-Reactive Protein (CRP), Procalcitonin and tumor necrosis factor alpha, have been proposed as a potential marker for screening neonatal sepsis
The diagnosis of neonatal sepsis is based on clinical assessment and the management rely on empirical treatment protocol which usually results in unnecessary hospital stay, increase irrational use of antibiotics and incur an unnecessary cost for the family [4, 5]
Most previous studies have established that CRP is a useful diagnostic test for the early stages of neonatal sepsis reaching a peak during the first 24-48 hours with better sensitivity and specificity
Summary
Nowadays various biochemical markers, such as C-Reactive Protein (CRP), Procalcitonin and tumor necrosis factor alpha, have been proposed as a potential marker for screening neonatal sepsis. We tried to see the diagnostic significance of White Blood Cell (WBC) count and CRP in diagnostic screening of neonatal sepsis. ; nowadays various biochemical markers, such as C-Reactive Protein (CRP), Procalcitonin (PCT), and tumor necrosis factor alpha (TNF-α), have been proposed as a potential marker for diagnosis of neonatal infection [6]. CRP is one of the most studied bio markers of neonatal sepsis which is available at most laboratory centers. Most previous studies have established that CRP is a useful diagnostic test for the early stages of neonatal sepsis reaching a peak during the first 24-48 hours with better sensitivity and specificity. Some are fully automated and quantitative, whereas others are semiquantitative or qualitative and manual [4 - 7]
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