Abstract

Aim: To evaluate the validity of C-Reactive Protein(CRP) in neonatal sepsis keeping blood culture as gold standard.

Study design: It is a cross sectional study of newborns with suspected sepsis.

Place and duration: The study was conducted in Newborn Intensive Care Unit, Department of Paediatrics Rangers Teaching Hospital, Lahore, from 1st November 2018 to 30th October 2019.

Methodology It was a cross sectional study of newborns with suspected sepsis. The study was conducted in Newborn Intensive Care Unit, Department of Paediatrics, Rangers Teaching Hospital, Lahore, from 1st November 2018 to 30th October 2019. 60 neonates (0-30 days of age) with clinical signs and symptoms suggestive of infection with positive blood culture were included in the study. CRP as a screening test was performed along with blood culture. Blood culture was considered as a gold standard. All neonates with clinical signs and symptoms suggestive of infection with positive blood culture were included in the study. Neonates who had already received antibiotic treatment for the same disease or during the same admission were excluded. After explaining the procedure and obtaining consent from the parents, neonates presenting with clinical suspicion of infection and culture proven sepsis were included in the study.

Results: In this study, a total of 60 neonates were studied, 36 patients were culture positive. Of these 21 were CRP positive also (Table 1). 10 neonates with positive CRP were culture negative. 15 subjects were culture positive with negative CRP. 14 neonates were both culture negative and CRP negative. Among the 36 patients with culture proven sepsis, 20(55%) were males while 16(44.44%) were females. 25 subjects (69.44%) were less than 5 days old. Mean age of onset was 4 days (range 1-25 days).

Conclusion: We concluded that the sensitivity, specificity, positive and negative predictive values as calculated in this study are not high enough to make it a good screening test. Considering the high morbidity and mortality associated with it, clinical criteria along with other hematological parameters and diagnostic markers along with CRP should be considered in evaluating a neonate for sepsis.

Keywords: C-reactive protein, Neonates, Neonatal Sepsis.