Evaluation of laboratory markers in early diagnosis of neonatal sepsis

Author(s): Swarna Devi K. S1, Jayaprakash K. P2, Thomas. P. Varghese3
1Junior Resident, Department of Pediatrics, Govt. Medical College, Kottayam, Kerala, India.
2Associate Professor, Department of Pediatrics, Govt. Medical College, Kottayam, Kerala, India.
3Assistant Professor, Department of Pediatrics, Govt. Medical College, Kottayam, Kerala, India.
Copyright © Swarna Devi K. S, Jayaprakash K. P, Thomas. P. Varghese. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Aim: Sepsis is a commonest cause of morbidity and mortality in the newborns and probably accounts for 30 to 50 percentage of neonatal death worldwide in developing countries so the study aimed to find out the most reliable laboratory parameter in early diagnosis of neonatal sepsis in comparison with blood culture in terms of Sensitivity, Specificity, Positive predictive value, Negative predictive value.
Material and Methods: A cross sectional study was conducted in the NICU and SCNU at Institute of Child Health, Government Medical College, Kottayam to evaluate the laboratory markers like total WBC count, I-T ratio, CRP, platelet count in early diagnosis of neonatal sepsis in comparison with blood culture. After taking informed consent from parents and permission from ethical committee, neonates brought to neonatology unit were selected by purposive sampling technique. Sample size was 120. All neonates having suspected sepsis were included. All neonates included in the study were started on empirical antibiotics after drawing samples for blood cultures, total WBC count, I-T.
Results: This study was designed to find out the most reliable parameter in early diagnosis of neonatal sepsis like total count, CRP, I-T ratio and platelet count in comparison with blood culture in terms of sensitivity, specificity, PPV and NPV.A total of 120 babies were studied who satisfied the inclusion criteria and ruling out those meeting exclusion criteria. Out of 120 babies studied early onset sepsis include 52.5% and late onset of sepsis include 47.5%.
Conclusion: This study proves that CRP is a test with good sensitivity and I-T ratio with maximum specificity but least sensitivity. These can be used for diagnosis of neonatal sepsis and treatment can be initiated before the blood culture results come.

Keywords: Sensitivity; Specificity; Positive predictive value; Negative predictive value; CRP; Sepsis.