Utility of C-reactive protein and hematological parameters in the detection of neonatal sepsis.

The present study was undertaken to find out and compare the usefulness of C-reactive protein (CRP) and hematological value with the blood culture in the diagnosis of neonatal sepsis. This prospective and cross sectional study was carried out in the Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period of July 2003 to January 2005. One hundred cases of suspected septicemia and fifty of controls were enrolled in this study. Blood was collected for the estimation of CRP, hematological parameters (total leukocyte count, differential count, platelet count) and blood culture from the newborns having suspected sepsis and CRP and hematological parameters from the control. CRP was raised in 72% of cases and 4% of control. Total leukocyte count (TLC) was elevated in a total of 10% cases and only in 4% controls. Leucopenia occurred in 6% cases. In 50% cases of culture proven sepsis there was thrombocytopenia. Sensitivity and specificity of CRP were 78.6%and 62.5% respectively in suspected neonatal sepsis & 92.86% and 36.11% respectively in culture proven sepsis. This study concluded that CRP is most sensitive method (93%) in culture proven sepsis and (79%) in suspected sepsis and its positive predictive value in suspected sepsis amounts to 88%. In this study among the suspected sepsis TLC and its differential count didn't show any positive results significantly but thrombocytopenia was present in 50% cases of culture positive sepsis. Therefore, CRP can be taken as alternate method for the diagnosis of neonatal sepsis specially in developing countries like Bangladesh.

Comparison between CRP and IL-6 as early markers of neonatal sepsis.

Infection in neonates is difficult to identify solely on the basis of physical findings, because signs are not specific. C reactive protein (CRP) is an acute phase reactant which has been used in diagnosis of bacterial infection in neonates. IL-6 is a proinflammatory cytokine produced by monocytes and macrophages activated by bacterial infection. IL-6 can be detected in blood earlier than CRP during the course of bacterial infection. The objective of this study was to compare the usefulness of the level of interleukin-6 with CRP as early markers of neonatal sepsis. This was a queasy experimental study carried out in neonatal unit, Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period of September 2005 to February 2006. Forty five cases of suspected septicemia were enrolled in the study and thirty healthy newborns were taken for comparison. On the 1st day of symptoms and 1st day of admission, complete blood count, blood for culture and sensitivity and interleukin-6 (IL-6) estimation were done. After 48-72 hours CRP was estimated. In suspected septic babies with high leukocyte count, IL-6 level was found to be raised with high sensitivity (85.71%), negative predictive value (95%). IL-6 was found to have high sensitivity (76.9%), specificity (73.68%), positive predictive value (80%) and negative predictive value (70%) in CRP positive suspected sepsis cases. So, the conclusion was that IL-6 is a very early marker of neonatal infection. IL-6 was mostly positive within 24 hours of onset of sepsis in comparison with other tests. So IL-6 is more useful than other markers for early detection of neonatal sepsis.