Role of C-Reactive Protein (CRP) as a screening tool in early diagnosis of neonatal septicemia

Sheenam Bindlish,Kmds Panag,Gitanjali Goyal

doi:10.7439/ijbr.v6i2.1588

Abstract

Background: Neonatal septicemia refers to generalized bacterial infection of neonate, which includes septicemia, pneumonia and meningitis. In developing countries one of leading factors for neonatal morbidity and mortality is bacterial sepsis. Aim: Early diagnosis of sepsis in the neonate is often difficult because symptoms and signs are usually non-specific. This study was conducted to evaluate C-reactive protein (CRP) as a screening tool for neonatal sepsis. Material and Methods: The study was conducted in Neonatal Intensive Care Unit in collaboration with Biochemistry Department at Guru Gobind Singh Medical College and Hospital, Faridkot from November 2013 to August 2014. 50 neonates were included with the age group of first 28days (4week) of life (infant age) in study. All of which were suspected to have sepsis in clinical settings. Patient with suspected sepsis having two or more of the following clinical features were used to identify patients: Respiratory and cardiovascular compromise, metabolic and neurologic changes. Blood samples were drawn prior to administration of antibiotic therapy on day one of admission for blood culture and CRP by trained staff with all aseptic precautions. Sample for blood culture was taken in blood culture bottle and the growth of bacteria was observed for 5 days after that they were reported and for CRP the investigation was performed by immunometric assay. Absolute neutrophil count and total leucocyte count was done by fully automated cell counter. Results: Among 50 septic screens, 39 (52%) patients had positive cultures, the sensitivity and specificity of ANC (Absolute Neutrophil Count) was 75% and 65.34%, TLC (Total Leucocyte Count) was 62% and 70.41%, CRP was 90 % and 83.21% respectively. This study also found that premature and low birth weight babies are more prone to neonatal sepsis. Conclusion: CRP is one of the most widely available, most studied, and most used laboratory tests for neonatal bacterial infection, and despite the continuing emergence of new infection markers, it still plays a central role in the diagnosis of early-onset sepsis of the neonate.

Highlights

Neonatal sepsis is defined as an invasive bacterial infection which occurs in the first 4 weeks of life
Proven Sepsis: These were the patients among suspected neonatal sepsis in which blood culture confirms sepsis or there is definite evidence of localized infection and C-reactive protein (CRP) >0.6 mg/dl
Probable Sepsis: These were the patients among suspected septic patient with CRP suggestive (≥0.6mg/dl) of septicemia but negative blood culture

Summary

Introduction

Neonatal sepsis is defined as an invasive bacterial infection which occurs in the first 4 weeks of life. The incidence of neonatal sepsis varies from 11-24.5 /1000 live births in India [1]. Sepsis is the commonest cause of mortality responsible for 30-50% of the 5 million total neonatal deaths each year. The reported incidence of neonatal sepsis varies from 7.1 to 38 per thousand live births in Asia [2]. Sheenam Bindlish et al/Role of CRP as a screening tool in early diagnosis of neonatal septicemia incidence varying from 0.1% to 4.5%. This study was conducted to evaluate C-reactive protein (CRP) as a screening tool for neonatal sepsis. Conclusion: CRP is one of the most widely available, most studied, and most used laboratory tests for neonatal bacterial infection and despite the continuing emergence of new infection markers and it still plays a central role in the diagnosis of early-onset sepsis of the neonate.

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Conclusion