Serum Procalcitonin and C Reactive Protein in as early markers neonatal sepsis- A prospective study

Abstract

Neonatal sepsis is one of the commonest causes of morbidity and mortality in neonates in India compared to the developed countries. Aim: To evaluate the Procalcitonin level this is an early marker in the diagnosis of neonatal sepsis and to assess the suitability of this test in the diagnosis of early-onset sepsis. Method: The prospective study was conducted in the Neonatal Division of Department of Pediatrics, Prathima Institute of Medical Sciences over a period of one year. The blood samples from 100 babies meeting the inclusion and exclusion criteria constituted the material for study. Result: Among the n=100 cases n=39 were procalcitonin positive, compared with gestational age 10 (43.5%) cases were positive with a gestation of <37 weeks and 24 (31.2%) cases positive of cases >37 weeks and there was no statistical significance concerning gestational age the association of material characteristics with procalcitonin positive and CRP positive levels. Blood culture was positive in n=9 (9%) of babies with (90% CI, 5.3-14.9) and negative in n=91 (91%) of babies with (90% CI, 85.2-94.7). Conclusion: A positive blood culture is the only definitive and gold standard for confirming a case of sepsis. Since the culture and sensitivity test requires a minimum period of 48 hours which is a precious time in deciding on the treatment of sepsis in the newborn. Rapid diagnosis by using Procalcitonin and CRP gives a reasonable degree of accuracy in diagnosing neonatal sepsis and will also guide antibiotic therapy. Procalcitonin in comparison with CRP has better sensitivity and hence can detect most cases of neonatal sepsis and better negative predictive value.