Diagnostic value of C- reactive protein and haematological parameters in neonatal sepsis.
OBJECTIVE
To analyse various parameters of sepsis screen singly and in combination to formulate a guideline for the diagnosis of neonatal sepsis.


METHODS
A cross-sectional analytical study.


METHODS
The neonatal intensive care unit at the Paediatric Department, Military Hospital, Rawalpindi, over a period of seven months from 1st June to 31st December 2003.


METHODS
One hundred neonates having clinical features of sepsis and 100 normal asymptomatic neonates were evaluated with a set of investigations. C-reactive protein (CRP), erythrocyte sedimentation rate, total leukocyte count, absolute neutrophil count (ANC), immature neutrophils to total neutrophil count ratio (I/T ratio), thrombocytopenia, degenerative changes in the neutrophils and gastric aspirate cytology (GAC) for polymorphs were used for diagnosis of neonatal sepsis.


RESULTS
CRP was positive in 24/28 (85.7%) of group-A (proven sepsis) and 58/72 (80.5%) of group-B (probable sepsis) and had a specificity of 95%. ANC was the second most sensitive test having sensitivity of 71.4 % for group-A and 63.9 % for group-B and 88% specificity. For group-A, sensitivity of GAC for polymorphs and platelet count was 71.4% and 64.3% respectively. The sensitivity, specificity and predictive values (PV) of the individual tests and different tests combination was also calculated for group-A and B.


CONCLUSIONS
A set of investigations including CRP, TLC, ANC, thrombocytopenia, cytoplasmic vacuolization in the neutrophils and GAC for polymorphs are highly sensitive in detection of culture negative cases of neonatal sepsis. Moreover, a combination of three tests enhances the sensitivity of these tests.
Ahmed
Zeeshan
Z
Department of Paediatrics, Military Hospital, Rawalpindi.
Ghafoor
Tariq
T
Waqar
Talal
T
Ali
Salman
S
Aziz
Shahid
S
Mahmud
Shahid
S
D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D006403:Hematologic Tests; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000453:epidemiology; D007958:Leukocyte Count; D008297:Male; D015997:Neonatal Screening; D010154:Pakistan / Q000453:epidemiology; D010976:Platelet Count; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D012720:Severity of Illness Index
D015415:Biomarkers; D002097:C-Reactive Protein