Diagnostic Value of C - Reactive Protein and Other Hematological Parameters in Neonatal Sepsis

Abstract

ABSTRACT:BACKGROUND:There have been many attempts to develop screening tests or scoring systems that can identify infected infants at the time of initial assessment, sparing others from invasive diagnostic procedures, intravenous antibiotics therapy, mother-infant separation and parental anxiety.OBJECTIVE:Is to analyze hematological parameters and C - reactive protein so as to evaluate their diagnostic value in neonatal sepsis.PATIENTS AND METHODS:A cross-sectional study was performed in the neonatal care unit (N.C.U) at the Central Teaching Hospital for Pediatrics and Al-Habibiya Maternity and Children Teaching Hospital during a period from the first of June 2005 to the first of January2006One hundred neonates having clinical features of sepsis and 100 normal asymptomatic neonates were evaluated with a set of investigations including C-reactive protein(CRP), White Blood cellsCount(WBC), Absolute Neutrophil count (ANC), Platelets count (thrombocytopenia), Immature to Total neutrophil ratio (I/T ratio) and Erythrocyte Sedimentation Rate (ESR) to diagnose neonatal sepsis.RESULTS:C-reactive protein (CRP) was positive in (82.4%) of group-A and (81.8%) of group-B and had a specificity of 93.0%. ANC was the second most sensitive test having sensitivity of 61.8% for group-A and 48.5% for group-B and specificity of 86.0%.The sensitivities of platelets count (thrombocytopenia), WBC, I/T ratio and ESR for group-A were: 55.9%, 29.4%, 17.6% and 26.5% respectively, with specificities of 91.0%,89.0%, 92.0% and 81.0% respectively. While group-B had sensitivities of 42.0%, 33.3%,15.2% and 22.7% respectively with specificities of 91.0%, 89.0%, 92.0% and 81.0%respective ly.CONCLUSION:The implementation of CRP and other hematological parameters (ANC, Platelets count and WBCs) are useful in early detection of neonatal sepsis and diagnosis of neonatal sepsis in those who have false negative blood cultures