Correlation between CRP and Blood Culture in Evaluation of Neonatal Sepsis

ABSTRACT

Ideal diagnosis and treatment strategies are difficult to define for Neonatal Septicemia and vary across the institutions. Clinical diagnosis is difficult because of early non-specific features. Mortality and morbidity due to sepsis can be prevented with early diagnosis and rational timely management. Non specific markers include CRP, leucopenia, Absolute Neutrophil Count, micro ESR (µ-ESR) , Procalcitonin etc. Amongst these CRP is easily available at many labs and is cost effective. Blood culture is considered as gold standard for diagnosis but it is costly and time consuming. Therefore, present study was done to compare and evaluate the CRP results with the blood culture reports and to provide a feasible, rapid and a relative economic method to diagnose neonatal septicemia. Methods: This Prospective Observational Study was done in the Pediatrics and Microbiology Departments of Government Medical College, Amritsar from 1st January 2017 to 31st December 2017. 270 neonates admitted with clinical suspicion of neonatal sepsis were included in this study. Neonates who received antibiotics prior to admission, with alternative diagnosis and/or with congenital malformations were excluded from the study. Blood culture was sent before starting antibiotics. CRP was done qualitatively by rapid slide latex agglutination method. Data analysis was carried out using computer software IBM SPSS and a p value of <0.05 taken as statistically significant. Results: We observed that 50.74% cases of neonatal sepsis were culture positive. CRP came out as a good predictor of sepsis with sensitivity, specificity, PPV, NPV and diagnostic accuracy of 83.9%, 34.5%, 56.93%, 67.64% and 66.78% respectively. Conclusion: Serum CRP can therefore be employed as a rapid screening test for neonatal sepsis.