EFFECTIVENESS OF SERUM PROCALCITONIN, C-REACTIVE PROTEIN AND HEMATOLOGICAL PARAMETERS VERSUS BLOOD CULTURE IN EARLY DIAGNOSIS OF NEONATAL SEPSIS IN NEONATAL INTENSIVE CARE UNIT
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Abstract
Background: Neonatal septicemia is a clinical condition portrayed by foundational indications of contamination in the primary month of life. It is the main source of neonatal horribleness and mortality in our country. The identification of microorganisms in a patient's blood is very important to know the nature of microorganisms and antibiotic susceptibility; to treat promptly.
Methods: The following tests were done on suspected cases of neonatal sepsis reported to our Institute. Blood culture to isolate the organism. Estimation of Serum Procalcitonin Level, Estimation of serial levels C-Reactive Protein, Estimation of Haematological parameters which included Haemoglobin, Total WBC counts, and Platelet counts. All the samples were collected at the time of admission before starting the antibiotics. 2nd sample of C Reactive Protein for estimation of serial levels is collected after 72 hours of antibiotic administration.
Results: Among the n=36 suspected cases of neonatal sepsis, n=23 were blood culture-positive cases. Among the culture-positive cases, 92.31% showed elevated CRP levels whereas 7.69% showed normal CRP levels. Out of n=13 blood culture-negative cases, 47.82% showed elevated CRP levels and 52.17% showed normal CRP levels. The sensitivity of CRP was 50% and the specificity was noted to be the highest which was 92.30%. The positive and negative predictive values were found to be 92.30% and 52.17% respectively. the sensitivity and specificity of PCT were 69.56% and 53.84% when compared to that of CRP 50% and 92.30%.PCT showed the highest sensitivity and CRP showed the highest specificity in the present study.
Conclusion: The most sensitive test was procalcitonin, which was followed by C-Reactive Protein and Total WBC counts. Out of all the indicators, C-Reactive Protein had the highest positive predictive value and specificity. Compared to other markers, procalcitonin was found to be a sensitive tool for early diagnosis, while C-Reactive Protein and Total WBC count were found to be less effective at predicting the outcome of sepsis.