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Biomarkers and Gold Standard: Assessing CRP, Procalcitonin, and Blood Culture in the Diagnosis of Neonatal Septicemia
Authors: MIHIRKUMAR J BHALODIA, Nidhi Mihirkumar Bhalodia, Kuntal Devesh Patel, Dr.Jasmin Jasani
DOI: 10.18231/j.ijmmtd.11903.1761394292
Keywords: Neonatal septicemia, Staphylococcus aureus, Acute phase reactant, C-reactive protein, Procalcitonin
Abstract: Background Neonatal septicemia is a leading cause of morbidity and mortality among newborns worldwide, posing a significant public health concern. (1) The incidence of neonatal sepsis ranges from 1 to 5 cases per 1000 live births, with an overall mortality rate of 24.4% (2,3). The present study was conducted to compare biomarkers, such as CRP and PCT, with blood culture for the diagnosis of neonatal sepsis. Methods The present study was conducted at a rural-based tertiary care hospital. All blood culture samples were processed in the BD BACTEC FX 40 automated blood culture system. Qualitative analysis of CRP was done by the latex agglutination test, and further quantitative analysis of positive samples was done using the MISPA-i3. Quantitative procalcitonin analysis was performed using the Finecare fluorescence immunoassay test Results In the present study, among the 330 sepsis cases, there were 243 (73.63%) cases of early-onset septicemia and 87 (26.36%) cases of late-onset septicemia. The blood culture results were positive in 175 patients (53.03%) out of 330 neonates. Among blood culture-positive samples, the highest prevalence was of Staphylococcus aureus (21.71%). The sensitivity and specificity of CRP in correlation with positive blood culture are 88.80% and 40.65%, respectively. The sensitivity and specificity of PCT in correlation with positive blood culture were 93.71% and 72.90%, respectively. The specificity of PCT is higher compared to CRP; thus, it is a more useful marker for diagnosing neonatal sepsis. Conclusion Procalcitonin (PCT) is an effective marker for diagnosing early-onset sepsis and can be utilized to monitor the response to antibiotic treatment.