Serial Serum C-reactive Protein in the Diagnosis of Neonatal Sepsis: A Cross-sectional Study

• Main Authors: Santhakumar Sundarapandian, Selvakumar Chinnakkannan, Shafath Ahmed M, Rashmi Ranjan Das
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2017-04-01
• Series: Indian Journal of Neonatal Medicine and Research
• Subjects: acute phase reactant; infection; mortality; newborn
• Online Access: http://www.ijnmr.net/articles/PDF/2206/24712_CE[VSU]_F(GH)_PF1(VsuGH)_PFA_NC(GH)_PF2(VsuGH).pdf

Introduction: C-reactive Protein (CRP) is an acute phase reactant secreted in increased amounts in the early hours of acute inflammation. Aim: To evaluate serial CRP levels for the diagnosis of neonatal infection and to do comparative analysis of CRP levels with other parameters of sepsis screen. Materials and Methods: Neonates with birth weight >1500 g and suspected to have sepsis were included. CRP was measured from the serum by quantitative turbidimetric immunoassay. The CRP 1 level was measured at the time of clinical presentation; CRP 2 and CRP 3 were measured at 24 and 48 hours respectively. Results: A total of 100 neonates were included. CRP was positive in 72% cases (CRP 2 in 59% and CRP in 72% cases). On comparative analysis of CRP with symptomatology, culture of the body fluid, WBC count, proven sepsis; serial CRP levels showed increase in sensitivity, decrease in specificity, not much change in Positive Predictive Value (PPV), but increase in Negative Predictive Value (NPV). CRP 3 was significantly associated with culture positivity. Conclusion: Serial CRP measurements are useful in the diagnosis of neonatal sepsis. CRP 3 level may virtually rule out or rule in the diagnosis of neonatal sepsis, and has very good correlation with blood culture.