Abstract:
Neonatal septicemia is a clinical syndrome of systemic illness
accompanied by bacteremia occuring in the first 28 days of
life. Neonatal septicemia is one of the major causes of
neonatal death in developing countries. Early diagnosis and
treatment can prevent neonatal mortality and morbidity. The
present study includes: 1) usefulness of CRP (C-reactive
protein), Total Leucocyte Count, Platelet Count and Blood
Culture in early diagnosis of Neonatal Sepsis, 2) significance
of serial CRP in diagnosis of neonatal sepsis. 3) the
prognostic value of CRP in neonatal sepsis. This is a
prospective study done in neonatal ward, Chittagong
Medical College Hospital and carried out from January
2008 to January 2011. Sample size was 300. One hundred
fifty neonates with suspected sepsis as cases and 150 healthy
babies as control were enrolled in this study. Seventy two
percent of cases neonates were preterm and low birth weight.
Common risk factors for neonatal septicemia which were
identified in this study; preterm (72%), low birth weight
(72%), premature rupture membrane (60%),
chorioamnionitis (26%) and maternal urinary tract infection
(16%) . Out of 150 cases of suspected neonatal sepsis total
80.7%% had raised CRP, in initial sample 70.39% were
CRP positive and in 2nd sample additional 9.31% case
were CRP positive . In control group 91% were CRP
negative. CRP was positive in 100% of culture proven sepsis.
Sensitivity of CRP was 80.67% and specificity of CRP was
76.44%. Leucocytosis was observed in 7% of cases and
leucopenia was found in 11% of cases. In 82 % cases
leucocyte count was found normal. In control group, 95%
had normal leucocyte count and 5% had leucocytosis but
no leucopenia. Sensitivity of leucocyte count was 18% and
specificity was 20.68%. Thrombocytopenia was found in
28% of case group. Out of 150 cases only 15.33% yielded
growth of organisms in blood culture. Klebsiella was the
most common pathogen isolated which was followed by
E.coli and Strph. aureus. Sensitivity of blood culture was
15.33% and specificity was 100% Therefore serial CRP
can be taken as alternative method for diagnosis of neonatal
sepsis specially in developing countries where blood culture
is not readily available.
Keyword: CRP in neonatal sepsis
(J Banagladesh Coll Phys Surg 2014; 32: 61-65)