Correlation of Proinflammatory Markers and Blood Culture in Neonatal Sepsis

Neonatal septicaemia is a clinical syndrome, occurs in the first 28 days of life, characterized by symptomatic systemic illness due to infectious agents. In India, 16.4% neonatal death is associated with neonatal sepsis. Blood culture is a gold standard for diagnosis. The aim of the study is to determine the effectiveness of blood culture in comparison to proinflammatory sepsis markers (C-Reactive Protein CRP, Procalcitonin PCT) in the diagnosis of neonatal sepsis. Total of 80 isolates were included in the study. Suspected new-born up to 28 days of life with high risk factors for sepsis admitted in NICU were drawn 3-5 ml of blood for culture and sensitivity and 1ml for detecting CRP by rapid test and procalcitonin by ELISA. Sensitivity and specificity of blood culture, CRP and procalcitonin were calculated. Among the 80 neonates suspected with sepsis, 77.5% had early onset and 22.5% had late onset. The blood culture isolation rate was 25%. Sensitivity of CRPwas 70% and specificity was 68.3% (p value 0.005). PCT had the highest sensitivity and specificity of 90% and 85% respectively (p value 0.0001). 12 samples showed both CRP and procalcitonin positive irrespective of blood culture report and 9 samples were both CRP and procalcitonin positive with culture proven cases. Despite its essential role in sepsis, procalcitonin still cannot be relied on as a sole marker. Culture occupies the center stage in diagnosing sepsis.