Early Diagnostic Markers for Neonatal Sepsis - Haematological Scoring System, C-Reactive Protein and Procalcitonin

Background: Neonatal sepsis is associated with high mortality and morbidity rate, as the clinical manifestations are nonspecific. Therefore, the need arises for early diagnostic markers of neonatal sepsis like Haematological scoring system (HSS), C-Reactive protein (CRP), Procalcitonin (PCT). Aim: To evaluate the role of diagnostic parameters HSS, CRP and PCT in the early detection of neonatal sepsis. Methods: 50 cases of neonatal sepsis were studied, HSS was calculated as per the 7 point Rodwell et al scoring system. PCT was calculated by the semi-quantitative kit. Statistical analysis: The results were compared with each other (comparative study design), with the gold standard (blood culture). Specificity, sensitivity, PPV& NPV were calculated. Result: Blood culture was Positive - 46 % cases, negative - 54 % cases, most common isolate obtained Coagulase negative staphylococcus aureus (CONS) 47.3 % cases, Staphylococcus aureus (34.78 % cases). HSS obtained Sepsis very likely - 56 % cases, Sepsis possible - 40 % cases, Sepsis unlikely - 4 % cases. CRP results obtained positive results - 60 % cases, negative - 40 % cases. PCT results were positive - 86 % cases and negative - 14 % cases. Conclusion: Among the various screening tests, PCT has higher sensitivity of 91.3 % as compared to CRP (73.9 %), HSS (65.2 %). Thus, PCT is a better marker for screening neonatal sepsis. However it is not very specific, can be raised in various other conditions.