Evaluation of C-reactive protein as early indicator of blood culture positivity in Neonates

摘要

Objective: To determine the Sensitivity, Specificity and Predict values of C - reactive protein as an early indicator of Neonatal Sepsis. Design: It was an observational study of newborns suspected sepsis. Place & Duration of study: The study was carried out in the Department of Paediatrics, Karachi Medical & Dental College and Abbasi Shaheed Hospital, Karachi over a period of eight months (March 1, 2001 to October 31,2001). Patient & Methods: Neonates admitted to intensive care nursery of the Abbasi Shaheed Hospital Karachi were evaluated for Neonatal Sepsis. C-reactive protein as screening test was performed along with blood culture from peripheral venepuncture. The gold standard for the Diagnosis of Sepsis was positive blood culture. Result: The positive C- reactive protein found in 14 of 21 episodes associated with the positive blood culture, but in 15 of 29 negative cases it was also found positive. The sensitivity and specificity are equal to negative predict value and positive predict value respectively i.e. 66.66% and 48.27%. Conclusion: CRP estimation have some value in early diagnosis of Neonatal sepsis but the frequent occurrence of raised CRP in sera of uninfected neonates eliminates it as a useful indicator of infection but may suggest an active tissue damaging process. We do not advocate to rely on the result of single test, even with the combination of test, we still stress the importance of correlating the clinical and laboratory data. We recommend that a scoring system should be designed for our setup, using those test that are easy to perform, economical, reliable, should have high predictive value and should ideally identify all infected infants (high sensitivity).