Role of Inflammatory Markers in Early Diagnosis of Neonatal Sepsis; C-Reactive Protein or Procalcitonin or Red Cell Distribution Width; A Hospital-Based Study
DOI:
https://doi.org/10.51253/pafmj.v73i6.9349Keywords:
C-reactive protein, Neonatal sepsis, Procalcitonin, Red cell distribution widthAbstract
Objective: To find out the utilization of C-reactive protein (CRP), Procalcitonin (PCT) and red cell distribution width (RDW) in
diagnosing neonatal sepsis considering blood culture findings as gold standard.
Study Design: Cross-sectional validation study.
Place and Duration of Study: Neonatal Intensive Care Unit (NICU) of Dr Ziauddin Medical University, Karachi Pakistan,
from Feb to Jul 2022.
Methodology: A total of 42 neonates of either gender with the clinical diagnosis of neonatal sepsis were enrolled.
Demographical and clinical characteristics of all neonates were noted at the time of enrollment. A blood sample of 5 ml was
withdrawn for the evaluation of CRP, PCT and RDS. The association of different inflammatory markers with the outcome
(neonatal sepsis) was assessed.
Results: In 42 neonates, the mean age was 7.24±9.24 days, and 26 (61.9%) neonates were boys. Respiratory distress, reluctance to feed and hypoglycemia were the most frequent clinical presentations observed (19,45.2%), (14,33.3%) and (8,19.0%) neonates, respectively. Mean CRP levels among blood culture positive and negative neonates were 40.02±57.84mg/dl and 7.57±13.34 mg/dl, respectively, while the difference was statistically significant (p=0.0068). RDW (p=0.6488) and procalcitonin (0.9021) levels were not statistically significant differences among positive and negative neonates of blood culture.
Conclusion: The CRP was a significant predictor of neonatal sepsis, while RDW and procalcitonin did not have a significant
relationship with early prediction of neonatal sepsis.
Downloads
Metrics
References
Mersha A, Worku T, Shibiru S, Bante A, Molla A, Seifu G, et al.,
Neonatal sepsis and associated factors among newborns in
hospitals of Wolaita Sodo Town, Southern Ethiopia. Res Reports
Neonatol 2019; 2019(9): 1-8.
https://doi.org/10.2147/RRN.S193074.
Fleischmann-Struzek C, Goldfarb DM, Schlattmann P,
Schlapbach LJ, Reinhart K, Kissoon N, et al. The global burden of
paediatric and neonatal sepsis: a systematic review. Lancet
Respir Med 2018; 6(3): 223-230.
https://doi.org/10.1016/s2213-2600(18)30063-8.
Yamey G, Horvath H, Schmidt L, Myers J, Brindis CD. Reducing
the global burden of Preterm Birth through knowledge transfer
and exchange: a research agenda for engaging effectively with
policymakers. Reprod Health 2016; 13(1): 26-28.
https://doi.org/10.1186/s12978-016-0146-8.
Rudd KE, Johnson SC, Agesa KM. Global, regional, and national
sepsis incidence and mortality, 1990-2017: analysis for the Global
Burden of Disease Study. Lancet 2020; 395(10219): 200-211.
https://doi.org/10.1016/s0140-6736(19)32989-7.
Ogundare E, Akintayo A, Aladekomo T, Adeyemi L, Ogunlesi T,
Oyelami O, et al. Presentation and outcomes of early and late
onset neonatal sepsis in a Nigerian Hospital. Afr Health Sci 2019;
(3): 2390-2399. https://doi.org/10.4314/ahs.v19i3.12
Giannoni E, Agyeman PKA, Stocker M, Klara MP, Heininger U,
Spycher BD, et al. Neonatal sepsis of early onset, and hospitalacquired and community-acquired late onset: A prospective
population-based cohort study. J Pediatr 2018; 201(1): 106-114.e4.
https://doi.org/10.1016/j.jpeds.2018.05.048.
Berardi A, Sforza F, Baroni L, Spada C, Ambretti S, Biasucci G, et
al. Epidemiology and complications of late-onset sepsis: an
Italian area-based study. PLoS One 2019; 14(11): e0225407.
https://doi.org/10.1371/journal.pone.0225407.
Gude SS, Peddi NC, Vuppalapati S, Venu Gopal S, Marasandra
Ramesh H, Gude SS, et al. Biomarkers of Neonatal Sepsis: From
Being Mere Numbers to Becoming Guiding Diagnostics. Cureus
; 14(3): e23215. https://doi.org/10.7759/cureus.23215.
Sampath S, Baby J, Krishna B, Dendukuri N, Thomas T. Blood
Cultures and Molecular Diagnostics in Intensive Care Units to
Diagnose Sepsis: A Bayesian Latent Class Model Analysis. Indian
J Crit Care Med 2021; 25(12): 1402-1407.
https://doi.org/10.5005%2Fjp-journals-10071-24051.
Ng S, Strunk T, Jiang P, Muk T, Sangild PT, Currie A. Precision
Medicine for Neonatal Sepsis. Front Mol Biosci 2018; 5:70
https://doi.org/10.3389%2Ffmolb.2018.00070.
Celik IH, Hanna M, Canpolat FE, Mohan P. Diagnosis of
neonatal sepsis: the past, present and future. Pediatr Res 2022;
(2): 337-350. https://doi.org/10.1038%2Fs41390-021-01696-z.
Jaswal RS, Kaushal RK, Goel A, Pathania K. Role of C-reactive
protein in deciding duration of antibiotic therapy in neonatal
septicemia. Indian Pediatr 2003; 40(9): 880-883.
Mally P, Xu J, Hendricks-Muñoz K. Biomarkers for neonatal
sepsis: recent developments. Res Reports Neonatol 2014; 4: 157-
http://doi.org/10.2147/RRN.S48316.
Jandial A, Kumar S, Bhalla A, Sharma N, Varma N, Varma S, et
al. Elevated Red Cell Distribution Width as a Prognostic Marker
in Severe Sepsis: A Prospective Observational Study. Indian J
Crit Care Med 2017; 21(9): 552-562.
https://doi.org/10.4103/ijccm.ijccm_208_17.
Sucilathangam G, Amuthavalli K, Velvizhi G, Ashihabegum MA,
Jeyamurugan T, Palaniappan N, et al. Early Diagnostic markers
for neonatal sepsis: comparing procalcitonin (PCT) and Creactive protein (CRP). J Clin Diagnostic Res 2012; 6(4): 627-631.
https://doi.org/10.7860/JCDR/2012/.2150.
Zhang K, Xie R, Li W. The application value of inflammatory
indicators and cytokine detection in the early diagnosis of
neonatal sepsis. Clin Blood Transfus Test 2019; 21(4): 435-436.
Yang T, Wang J. Comparison of pathogenic bacteria, cytokines
and immune function of sepsis between term and premature infants. Chinese J Emerg Resuscit Disaster Med 2020;
(2): 201–203.
Wu L, Li J, Ping L, Zhang X, Zhai L, Li Y, et al. Diagnostic Value
of Inflammatory Markers and Cytokines in Neonatal Sepsis. Evid
Based Complement Alternat Med 2022; 2022: 4143101.
https://doi.org/10.1155%2F2022%2F4143101.
Xu L, Li Q, Mo Z, You P. Diagnostic value of C-reactive protein
in neonatal sepsis: A meta-analysis. Europ J Inflamm 2016; 14(2):
-108. https://doi.org/10.1177/1721727X16646787.
Rashwan NI, Hassan MH, Mohey El-Deen ZM, Ahmed AE.
Validity of biomarkers in screening for neonatal sepsis - A single
center -hospital based study. Pediatr Neonatol 2019; 60(2): 149-
Downloads
Published
How to Cite
Issue
Section
