Correlation of Endotoxin and hs–CRP levels with Blood Culture in Suspected Neonatal Sepsis – A pilot study

Mr.Prithivi Raaj.P; Dr.N.Bharathi Santhose

Volume : VIII, Issue : IV, April - 2019

Correlation of Endotoxin and hs–CRP levels with Blood Culture in Suspected Neonatal Sepsis – A pilot study

Mr. Prithivi Raaj. P, Dr. N. Bharathi Santhose

Abstract :

Neonatal sepsis is a major cause of morbidity and mortality worldwide, causing around 2.7 million deaths annually, 99% of which is attributed by developing countries. Gram negative bacteria are responsible for majority of neonatal sepsis. One of the greatest challenges to the medical fraternity is getting an accurate and early diagnosis of neonatal sepsis as new–borns have very subtle clinical presentations, unlike their adult counterparts and also due to the fact that a wide array of conditions mimic neonatal sepsis clinically .Because of limitations of blood culture like low sensitivity and time consuming, a wide spectrum of auxiliary tests using diagnostic markers like C–reactive protein (CRP), Pro–calcitonin (PCT) and Endotoxin assays has now emerged to aid in the presumptive as well as confirmatory diagnosis of neonatal sepsis. The present study was to evaluate the diagnostic efficacy of Endotoxin and hs–CRP as an alternative tool in early diagnosis of neonatal sepsis. 50 suspected case of neonatal sepsis studied, most of the cases were less than 5 days of age, 60% were positive and 48% were negative by blood culture. 84% were due to Gram negative bacterial sepsis and only 16% were Gram positive bacterial sepsis. The most common risk factor was Low birth weight (74%). Birth asphyxia (48%) followed by PROM (24%). The sensitivity and specificity of hs–CRP were 100% and 76% respectively. The sensitivity and specificity of endotoxin were 84% and 68% respectively. Considering Gram negative bacterial sepsis alone, the sensitivity and specificity of endotoxin was found to be 100% and 100% respectively.