Role of Procalcitonin and C-Reactive Protein in the Early Diagnosis of Neonatal Sepsis

Abstract

Introduction: Neonatal Sepsis (NS) is responsible for 30-50% of total neonatal deaths in developing countries. Blood culture is gold standard diagnostic test but has a low yield and is the time consuming. C-Reactive Protein (CRP) and Procalcitonin (PCT) are commonly used for diagnosis of sepsis. Aim: To study the role of CRP and PCT in the screening of NS and to compare PCT and CRP in relation to sensitivity, specificity and accuracy. Materials and Methods: A cross-sectional study was conducted inatertiarycareNeonatalIntensiveCareUnit(NICU)fromFebruary 2018 and November 2019. Neonates with signs and symptoms of sepsis or born to mothers with risk factors for sepsis were included. Those who received antibiotic before admission or had co-morbidities such as meconium aspiration, birth asphyxia, etc., were excluded. Investigations for sepsis including Complete Blood Count (CBC), CRP, PCT and Blood Culture were done. They were classified into three groups as group 1 clinical sepsis, group 2 suspected sepsis and group 3 confirmed sepsis. The statistical test used was Analysis of Variance (ANOVA) test and tests for sensitivity, specificity, positive predictive value, negative predictive value were also used. Results: The sensitivity, specificity, PPV, and NPV of CRP and PCT versus culture report were evaluated. The sensitivity was 61.90% and 90.47%, specificity was 72.45% and 82.75%, PPV was 61.90% and 79.16% and NPV was 72.45% and 92.30% for CRP and PCT, respectively. The accuracy of the test was 68.00% and 86.00% for CRP and PCT, respectively. Conclusion: PCT is a better septic marker than CRP in relation to sensitivity, specificity and accuracy and correlates positively with blood culture.