Procalcitonin and C-reactive protein in early diagnosis of neonatal sepsis

Abstract

ABSTRACT Background Blood culture is the gold standard for diagnosis of neonatal sepsis, however culture negative sepsis is suspected by high C-reactive protein (CRP) and procalcitonin (PCT) levels. The aim of this study was to compare the diagnostic accuracy of PCT as compared to CRP in diagnosis of neonatal sepsis. Methods Blood samples of 200 neonates with 98 sepsis group and 102 non-sepsis group were analysed for CRP, PCT and culture from December 2012 to July 2013. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of PCT was determined compared to CRP. Results The study group included 56% male and 44% female babies. CRP was raised in 65/98 whereas PCT in 76/98 in sepsis group and in non sepsis group it was 24/102 for CRP and 21/ 102 for PCT. Sensitivity, specificity, positive predictive value, and negative predictive value of PCT was 77.55%, 79.41%, 78.35% and 78.64% respectively as compared to 66.33%, 76.47%,73.03%, 70.27% for CRP respectively. Diagnostic accuracy of PCT was higher at 78.5% as compared to 71.5% for CRP. Conclusion PCT is a better diagnostic marker for early diagnosis of neonatal sepsis as compared to CRP, where blood culture though a gold standard for diagnosis of neonatal sepsis, shows growth in only around 23% of sepsis cases. Diagnosis of neonatal sepsis by blood culture takes up to 72 h and hence use of PCT as a diagnostic marker can minimise this delay in diagnosis. Copyright © 2014, Indian Journal of Medical Specialities. Published by Reed Elsevier India Pvt. Ltd. All rights reserved.