Introduction: Neonatal sepsis refers to a bloodstream infection which impacts infants under 28 days of age. Symptoms may encompass irregular vital signs and respiratory discomfort. C-reactive protein served as a vital diagnostic marker; nevertheless, its low sensitivity in early identification necessitates periodic assessments for accurate diagnosis and therapy monitoring. Aims: This study assessed C-reactive protein levels, cellular parameters, and clinical indicators in neonates predisposed to sepsis at a tertiary care facility. Methods: Hospital based prospective study, conducted on 150 neonates in paediatrics and biochemistry department of Nepalgunj Medical College from June 2024 to October 2024. C-reactive protein, whole blood count, platelets count, Immature/ total neutrophil ratio were calculated along with the clinical findings suggesting sepsis were recorded. Major neonatal anomalies and prior antibiotic use led to exclusion. Results: Among 150 at-risk neonates, 65.3% were male, 46% were preterm and 45.3% had low birth weight. Elevated C-reactive protein (>6 mg/L) was found in 84.7%, with 68% showing tachypnea and 53.3% delayed capillary refill. Temperature variability (90%) and tachycardia (70%) were common. Laboratory findings showed high C-reactive protein (mean 16.8 mg/L), neutrophil predominance (61%), and raised Immature to total neutrophil ratio (0.25). Late-onset cases had more severe clinical and inflammatory profiles than early-onset cases. Conclusion: C-reactive protein, as a biochemical marker, was observed in the majority of neonates at risk of sepsis, while temperature variability, tachycardia and reduced urine output were common clinical features indicating systemic compromise.
Sapkota et al. (Wed,) studied this question.
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