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

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 nonspecific. 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 the Department of Biochemistry at Guru Gobind Singh Medical College and Hospital, Faridkot retrospectively 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 and it still plays a central role in the diagnosis of early-onset sepsis of the neonate.

Diagnostic Markers for Early Detection of Neonatal Sepsis

“…Unnecessary and increased antibiotic consumption leads to a higher incidence of the side-effects due to their use, increased resistance to antibiotics, a long hospitalization and increased health costs. Therefore, using fast diagnostic methods including laboratory markers could be beneficial for the diagnosis of neonatal sepsis (Bindlish et al, 2015).…”

Microbiological study of cases of early neonatal sepsis and evaluation of the role of C-reactive protein, interleukin-6 and interleukin-8 as diagnostic biomarkers of such cases

“…Unfortunately, these tests do not have a high sensitivity and specificity in diagnosing neonatal sepsis. CRP has also been used for long time as a biomarker for infection as it is simple, fast and effective but its sensitivity and specificity became a matter of questions Meanwhile, infants who are suspected to have neonatal sepsis have to start antibiotic treatment which could be unnecessary and even harmful with higher incidence of antibiotic resistance and longer hospitalization with increased health costs (Bindlish et al, 2015). Therefore, efforts have been made to improve diagnosis and to find the ideal rapid biomarker that provides high sensitivity and specificity for diagnosis of presence or absence of sepsis, severity of sepsis, type of microorganisms, and prognosis during treatment (Modi et al, 2009).…”