Validity of C-reactive protein (CRP) for diagnosis of neonatal sepsis.

Effat Hisamuddin,Aliya Hisam,Sughra Wahid,Ghulam Raza

doi:10.12669/pjms.313.6668

Abstract

Objective:To determine the validity of C-reactive protein levels for diagnosis of neonatal sepsis.Methods:A cross sectional (Validation) study was conducted at Neonatology unit in KRL general hospital (emergency/OPD) of 7 months duration from February 2012 to August 2012. By using purposive sampling technique, 147, sample size was calculated by using WHO sample size calculator taking sensitivity 75%, specificity 95%, expected prevalence 50%, desired precision 10% and confidence level 95%.Results:Mean age of the neonates was 5.72 days + 3.86. Male patients were 81(55.1%) while 66(44.9%) were female. Neonatal sepsis was observed in 43(29.25%) and were confirmed through blood culture while 104(70.75%) were not confirmed on blood culture as neonatal sepsis. The sensitivity and specificity of CRP in diagnosis of acute neonatal sepsis was 76.92% and 53.49% respectively while it had a positive predictive value of 80% and negative predictive value of 48.94%. Over all the diagnostic accuracy of CRP in diagnosis of neonatal sepsis was 70.07%.Conclusion:CRP estimation does have a role in the diagnosis of neonatal sepsis but the test is not specific enough to be relied upon as the only indicator.

Highlights

Septicaemia is a recognised cause of morbidity and mortality in the new-borns in the developing countries.[1]
This study aimed to examine the part of C-reactive protein (CRP) in neonatal sepsis to see if it can be used as a tool to find the time period when antibiotics treatment can be safely discontinued in case of suspected neonatal septicaemia
Suspected neonatal sepsis was considered if neonate had clinic pathological features of perinatal risk factors i.e. maternal pyrexia, prolonged rupture of membranes (18 hours), foul smelling vaginal discharge or/and maternal urinary tract infection diagnosed in last month

Summary

Introduction

Septicaemia is a recognised cause of morbidity and mortality in the new-borns in the developing countries.[1] Septicaemia is well-defined as a “clinical syndrome characterized by systemic signs/ symptoms and bacteraemia during the 1st month of life”. The primary threatening signs and symptoms are mostly nonspecific and can be mixed up with the non-infective causes. Nonspecific signs/symptoms makes it very challenging to formulate a timely clinical diagnosis.[3] Neonatal physician after evaluating many test are looking for a test that would help in neonatal sepsis diagnosis and quickly confirms it and that decisively rules it out.[4] Diagnostic test like blood cultures are time consuming so correct diagnosis gets delayed and problematic

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Discussion

Conclusion