Title: Study to Evaluate the Role of High Sensitivity – C Reactive Protein (hsCRP) in the early Diagnosis of Neonatal Sepsis

Authors: Dr M.Muralidharan, Dr S.Ramesh, Dr S. Saravanan, Dr S. Chidambaranathan, Dr Praveenkumar

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i11.30

Abstract

Background: Neonatal sepsis is a clinical syndrome of bacteremia characterized by systemic signs and symptoms of infection in the first month of life. Neonatal sepsis encompass systemic infection of the newborn including septicemia, meningitis, pneumonia, arthritis, osteomyelitis and urinary tract infection of the newborn1. The contribution of neonatal sepsis to high morbidity and mortality rate makes it an important subject for research so as to find out the possible solution. Prompt diagnosis of neonatal sepsis is of paramount importance. As there is no rapid and reliable test yet for the diagnosis of neonatal sepsis, serial HS-CRP measurement can be used for its early detection as well as exclusion of infection in the neonates.

Methodology: The current study is a prospective study conducted among 150 neonates admitted in the department of Paediatrics, Rajah Muthiah Medical College and Hospital, Chidambaram with clinical suspicion of sepsis by purposive sampling technique from October 2016 to October 2018. Detailed history and venous blood samples were collected from all neonates, clinical and laboratory parameters were recorded and analysed.

Results: The qualitative CRP levels with a cut off value greater than 6.0mg/l showed a sensitivity of 69.74% and specificity of 71.62% with a diagnostic accuracy of 70.67%. The HSCRP-1 collected within 12 hours of onset of symptoms with a cut of value ≥3mg/lt showed a sensitivity of 93.42% and specificity of 91.89% with a diagnostic accuracy of 92.67%. HSCRP-2 collected 24 hours later with a cut of value ≥3mg/lt showed a sensitivity of 98.68% and specificity of 93.24% with increased diagnostic accuracy of 96.0%.

Conclusion: Serial measurement of High Sensitivity CRP measured quantitatively is more sensitive and specific in diagnosing neonatal sepsis with increased diagnostic accuracy and found to be more superior to conventional method of measuring CRP qualitatively.

Keywords: Neonatal Sepsis, CRP, HSCRP, Culture Positive Sepsis.

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Corresponding Author

Dr S. Saravanan

Associate Professor, Department of Paeditrics, RMMCH, Chidambaram-608002, Tamilnadu, India

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