DAIGNOSTIC VALUE OF C-REACTIVE PROTEIN AND HAEMATOLOGICAL MARKERS IN NEONATAL SEPSIS

Background: Early diagnosis of neonatal sepsis is often difficult because of the non-specific symptoms and signs. An attempt to set a screening test that can identify infected infants at the time of initial presentation, sparing others from invasive procedures, antimicrobial therapy and parent's anxiety especially by mother infant separation is a challenging task for a neonatologist. The objective of this study was to determine the diagnostic value of C-reactive protein and other hematological marker in predicting early neonatal sepsis. Material & Methods: A retrospective study was conducted at the NICU of Rehman Medical Institute, Peshawar. A total of 700 neonates with age group of first 28 days of life were included in the study, all of which were suspected to have sepsis on clinical settings. All the neonates were investigated by sending blood to the laboratory for blood culture, CRP, and complete blood count and the final results were compared. Results: Sepsis was confirmed in 54% of cases on the basis of positive blood culture. Among the hematological markers, CRP was the most sensitive and specific test with sensitivity and specificity of 88.36% and 89.13% respectively, followed by platelet counts with sensitivity of 87.04%. Absolute Neutrophil Count and WBC had the sensitivity of 84.39% and 84.13%. Conclusion: There is no ideal test for the diagnosis of early or late-onset neonatal sepsis. Physical examination has an important role in identifying infants at low risk for sepsis. Sepsis markers like CRP and neutrophil indices are useful adjunct tests in identifying infants with a low probability of infection.