Volume : VIII, Issue : II, February - 2019

PROCALCITONIN AND CRP MARKERS IN NEONATAL SEPSIS

Rajiv Ranjan, Swami Jerupula, D. K. Bhagwani

Abstract :

 

Introduction: Neonatal sepsis is a major cause of mortality in developing countries. Accurate and quick diagnosis IS  difficult because clinical presentation is non–specific, bacterial cultures are time–consuming and other laboratory tests lack sensitivity and specificity. Serum procalcitonin (PCT) and C Reactive Protein (CRP) have been proposed as an early marker of infections in neonates.

Aims & Objectives: – To study the sensitivity and specificity of CRP and PCT in diagnosis of Neonatal sepsis and to study the role of serial quantitative CRP and PCT in guiding course and duration of antibiotic therapy in Neonatal sepsis.

Method:– Neonates undergoing sepsis evaluation at the Neonatal Intensive Care Unit, Hindu Rao Hospital between September 2013 to September 2015 were included. Blood samples were obtained for white cell count, blood cultures, serum CRP and PCT analysis. Neonates were categorised into Proven Sepsis, Suspected Sepsis and Clinical Sepsis groups on the basis of laboratory findings and risk factors. A control group with no clinical and biological data of infection was also included. Predictive values and area under the receiver operating characteristic curve (AUC) of PCT were evaluated.

Results: Out of the various individual tests for rapid diagnosis of neonatal septicemia, in combined definite & clinical sepsis group, CRP was positive in (73.33%) with sensitivity of (73.33%), specificity of (86.67%), PPV (92.27%), NPV (58.21%) with p value of (<0.001) which is statistically highly significant in combined sepsis. For early and rapid detection of neonatal sepsis in definite & clinical sepsis group, PCT was positive in (91.43%) with sensitivity of (91.43%), specificity of (91.11%), PPV (96.00%), NPV (82.00%) with p value of (<0.001) which is statistically highly significant in definite & clinical sepsis. In our study it is evident that PCT is early and better marker than CRP in detecting septicemia, PCT has better sensitivity, specificity, PPV & NPV than CRP in all weight groups. It is also observed that sensitivity, specificity, PPV and NPV of the PCT & CRP were higher in >2500 grams babies than other two groups. From our study it was evident that the recommended mean duration of therapy was much lesser than what was  used routinely. In definite sepsis mean duration of therapy was (9.43+–3.93 days), in clinical sepsis (7.11+–2.84 days), in sepsis ruled out group (2.42+–1.1days) by serial measurement of PCT.

Conclusion: – These findings support the usefulness of the PCT in diagnosis and duration of treatment of Neonatal sepsis.

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Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

PROCALCITONIN AND CRP MARKERS IN NEONATAL SEPSIS, Rajiv Ranjan, Swami Jerupula, D.K.Bhagwani INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-8 | Issue-2 | February-2019

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