DIAGNOSTIC ACCURACY OF C-REACTIVE PROTEIN IN NEONATAL SEPSIS USING BLOOD CULTURE AS GOLD STANDARD: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.66604/yfmbm587Keywords:
C - reactive protein, Neonatal sepsis, Blood culture, Diagnostic accuracyAbstract
Background: Neonatal sepsis is a life-threatening but treatable condition if diagnosed early, though its nonspecific signs can delay detection. C-reactive protein (CRP) is a helpful marker, but its diagnostic accuracy varies. This study evaluates CRP’s accuracy in diagnosing neonatal sepsis, using blood culture as the gold standard. Methods: This cross-sectional study was conducted at the Paediatric department of Ittifaq Hospital, Lahore, over a six-month period. A total of 150 patients were included. After fulfilling the study criteria, Informed consent from either parent, as well as a detailed history and a blood sample, were taken for CRP and blood culture tests. All data were analysed using SPSS-24. The data were stratified by age and gender to address the issue, and a chi-square test was applied with a p≤0.05 considered significant. Result: Among the total 150 patients, the mean age was 14.46±7.61 days, with 64 (42.7%) females, and the mean CRP was 10.97±13.23. CRP was found positive in 47 (31.33%) patients, whereas Blood culture was positive in 45 (30.00%). The sensitivity and specificity of CRP were 93.33% and 95.24% respectively, with an overall diagnostic accuracy of 94.67%. A significant association was also found between blood culture and CRP, p<0.001. Conclusion: CRP is a good diagnostic tool for diagnosing neonatal sepsis. Using this simple test, an accurate and timely diagnosis can be made, and it can help initiate early medical treatment for these high-risk cases. These findings support CRP’s utility for ruling out sepsis and guiding early antibiotic discontinuation.
References
Raturi A, Chandran S. Neonatal sepsis: aetiology, pathophysiology, diagnostic advances and management strategies. Clin Med Insights Pediatr 2024;25;18:11795565241281337. DOI: https://doi.org/10.1177/11795565241281337 DOI: https://doi.org/10.1177/11795565241281337
Celik IH, Hanna M, Canpolat FE, Mohan Pammi. Diagnosis of neonatal sepsis: the past, present and future. Pediatr Res 2022;91(2):337–50. DOI: https://doi.org/10.1038/s41390-021-01696-z DOI: https://doi.org/10.1038/s41390-021-01696-z
Fleischmann C, Reichert F, Cassini A, Horner R, Harder T, Markwart R, et al. Global incidence and mortality of neonatal sepsis: a systematic review and meta-analysis. Arch Dis Child 2021;106(8):745–52. DOI: https://doi.org/10.1136/archdischild-2020-320217 DOI: https://doi.org/10.1136/archdischild-2020-320217
Odabasi IO, Bulbul A. Neonatal Sepsis. Sisli Etfal Hastan Tip Bul 2020;54(2):142–58. DOI: https://doi.org/10.14744/SEMB.2020.00236 DOI: https://doi.org/10.14744/SEMB.2020.00236
Singh M, Alsaleem M, Gray CP. Neonatal Sepsis. 2022 Sep 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025.
Kosmeri C, Giapros V, Serbis A, Baltogianni M. Application of advanced molecular methods to study early-onset neonatal sepsis. Int J Mol Sci 2024;25(4):2258. DOI: https://doi.org/10.3390/ijms25042258 DOI: https://doi.org/10.3390/ijms25042258
Du LZ. Early diagnosis and management of neonatal sepsis: a perspective. World J Pediatr 2024:20: 303–6. DOI: https://doi.org/10.1007/s12519-024-00803-4 DOI: https://doi.org/10.1007/s12519-024-00803-4
Ahmed KA, Khan MA, Naqvi SZ, Mughal IA, Zia MS, Idrees A. Combining complete blood count with differential count, C-reactive protein, and band neutrophils in the diagnosis of early-onset neonatal sepsis. Pak J Med Health Sci 2022;16(9):168–9. DOI: https://doi.org/10.53350/pjmhs22169168 DOI: https://doi.org/10.53350/pjmhs22169168
Irshad M, Hayat M, Parvez H, Ihsan Ullah, Zia ur Rehman. Neonatal sepsis: diagnostic accuracy of C-reactive protein (CRP) in the diagnosis of neonatal sepsis. Professional Med J 2019; 26(4):608–14.DOI: https://doi.org/10.29309/TPMJ/2019.26.04.3362 DOI: https://doi.org/10.29309/TPMJ/2019.26.04.3362
Aslam F, Sipra MWK, Zakir FA, Anwar ZUA, Shaukat A. The clinical significance of CRP and IL-6 in early recognition of neonatal sepsis. Pak J Pathol 2024; 35(1):13–19. DOI: https://doi.org/10.55629/pakjpathol.v35i1.775 DOI: https://doi.org/10.55629/pakjpathol.v35i1.775
Hisamuddin E, Hisam A, Wahid S, Raza G. Validity of C-reactive protein (CRP) for diagnosis of neonatal sepsis. Pak J Med Sci 2015;31(3):527–1. DOI: https://doi.org/10.12669/pjms.313.6668 DOI: https://doi.org/10.12669/pjms.313.6668
Younis S, Shiekh MA, Raza AA. Diagnostic Accuracy of C-Reactive Protein in Neonatal Sepsis. J Bioresour Manag 2014;1(1):33–42 DOI: https://doi.org/10.35691/JBM.4102.0001 DOI: https://doi.org/10.35691/JBM.4102.0001
Liu Y, Zhao L, Wu Z. Accuracy of C-Reactive Protein Test for Neonatal Septicemia: A Diagnostic Meta-Analysis. Med Sci Monit 2019;25:4076–81. DOI: https://doi.org/10.12659/MSM.916968 DOI: https://doi.org/10.12659/MSM.916968
Al-Atwi SS, Al-Atwi MA, Al-Balawi MS, Al-Balaw MK. Assessing the diagnostic accuracy of C-reactive protein (CRP) in neonatal sepsis detection. J Popul Ther Clin Pharmacol 2023;30(1): 415–23. DOI: https://doi.org/10.53555/jptcp.v30i1.4681
Eichberger J, Resch E, Resch B. Diagnosis of neonatal sepsis: The role of inflammatory markers. Front Pediatr 2022;10:840288. DOI: https://doi.org/10.3389/fped.2022.840288 DOI: https://doi.org/10.3389/fped.2022.840288
Bunduki GK, Adu-Sarkodie Y. The usefulness of C-reactive protein as a biomarker in predicting neonatal sepsis in a sub-Saharan African region. BMC Res Notes 2020;13(1):194. DOI:https://doi.org/10.1186/s13104-020-05033-1 DOI: https://doi.org/10.1186/s13104-020-05033-1
Mouliou DS. C-reactive protein: pathophysiology, diagnosis, false test results and a novel diagnostic algorithm for clinicians. Diseases 2023;11(4):132. DOI: https://doi.org/10.3390/diseases11040132 DOI: https://doi.org/10.3390/diseases11040132
Samuel L. Direct-from-Blood detection of pathogens: a review of technology and challenges. J Clin Microbiol 2023;61:e00231–21. DOI: https://doi.org/10.1128/jcm.00231-21 DOI: https://doi.org/10.1128/jcm.00231-21
Vieira RC, Procianoy RS, Mulle LD, Prado CH. Repercussão da antibioticoterapia materna intraparto no diagnóstico de sepse neonatal precoce [The influence of intrapartum antibiotic therapy on the diagnosis of early-onset neonatal sepsis]. J Pediatr (Rio J). 1997;73(3):171–5. Portuguese. DOI: https://doi.org/10.2223/jped.527 DOI: https://doi.org/10.2223/JPED.527
Herzlich J, Waksman Y, Marom R, Berliner S, Mandel D, Mangel L. Determinants of CRP measurements and CRP dynamics during early neonatal sepsis workup. Sci Rep 2025;15,18031. DOI: https://doi.org/10.1038/s41598-025-02337-9 DOI: https://doi.org/10.1038/s41598-025-02337-9
Weitkamp JH, Aschner JL. Diagnostic Use of C-Reactive Protein (CRP) in Assessment of Neonatal Sepsis. Neoreviews 2005;6(11):e508–15. DOI: https://doi.org/10.1542/neo.6-11-e508 DOI: https://doi.org/10.1542/neo.6-11-e508
Kumar D, Khan M, Shaikh M, Hanif M, Hussain W. Sensitivity and specificity of C-reactive protein against blood culture in patients with neonatal sepsis - A hospital-based study. Liaquat Natl J Prim Care 2024;6(1):14–7.
Paolucci M, Landini MP, Sambri V. How Can the Microbiologist Help in Diagnosing Neonatal Sepsis?, Int J Pediatr 2012;2012:120139. DOI: https://doi.org/10.1155/2012/120139 DOI: https://doi.org/10.1155/2012/120139
Siddaiah P, Shetty PN, Karishna NW, Jagadeeshwara S. A study on validity of C-reactive protein in deciding the duration of antibiotic therapy in suspected neonatal bacterial infection. Int J Contemp Pediatr 2017;4(5):1838–43. DOI: https://doi.org/10.18203/2349-3291.ijcp20173796 DOI: https://doi.org/10.18203/2349-3291.ijcp20173796
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