Correlation of Blood culture with C-Reactive Protein , WBC count in the diagnoses of Bacterial Neonatal Sepsis

Abstract

Abstract

Introduction

The diagnosis of sepsis in neonates is challenging.  C- reactive protein (CRP), White blood cell counts are the widely used

 biomarkers in neonatal sepsis screening by clinicians.

Aim

 To assess the value of C-reactive protein alone and in combination with total White Blood Cell (WBC) count in screening of

neonatal sepsis.

Materials and Methods

A retrospective study   was conducted from March   to November 2018 at  R L Jalappa Hospital& Research centre ,  Kolar,

Karnataka, India. Data was analysed using SPSS version 22.0 statistical software for further analysis. Sensitivity, specificity,

 positive predictive value (PPV) and negative predictive value (NPV) were used the accuracy of CRP and WBC taking

 blood culture as gold standard.

Results

Data of 127 neonates with clinical neonatal sepsis were   analysed.  Blood culture was positive in 28  (22.04 % )  neonates. 

CRP   was positive in   20 (71.42% ) blood culture positive cases.  Out of 99   culture negative cases ,   WBC changes were noted

 with 30 (30.30%) of cases . The    sensitivity , specificity of CRP were 71.4%, 69.9% respectively with positive predictive value (PPV)  of 36.6% and negative predictive value(NPV)  88.89%. On the another hand,   sensitivity and specificity of WBC were  21.43% and 78.79% with PPV and NPV of 22.22% and  78.5% respectively.  When   positive   CRP   was   combined   with  total  WBC count  the sensitivity and specificity was   raised to 78.57% and 81.81% respectively.

Conclusion

In resource limited settings for blood cultures , the positive CRP assay in combination with   raised WBC counts in neonates with clinical features of sepsis should be considered for immediate management of neonatal sepsis to reduce the morbidity and mortality.

Key Words :       Neonatal sepsis,  CRP,