Abstract
Introduction: Neonatal septicaemia constitutes a significant cause of morbidity and mortality of neonates in India. The diagnosis of neonatal septicemia based on clinical manifestations is nonspecific which leads to initiation of unnecessary antibiotic treatment. Blood culture remains the gold standard for the diagnosis of neonatal sepsis. But many times, culture may be negative in symptomatic neonates, preterm neonates or very low birth weight babies. Further difficulty with blood culture is turnaround time of at least 18-24hrs and this facility is available only in well-equipped centers. C-reactive protein (CRP) production is a nonspecific response to a disease but along with clinical symptoms, it is helpful for the diagnosis of neonatal septicaemia. Methods: In this one year prospective study, 257 clinically suspected cases of neonatal septicaemia were enrolled. Screening for CRP was done by quantitative method and cut off value of CRP was taken as 6mg/l. Simultaneously, blood culture was done by automated BACTEC 9240 system. Results: Out of 257 cases, 67 showed positive CRP and 20 cases showed positive blood culture. The predominant organisms were Staphylococcus species followed by Escherichia coli. CRP test showed 50% sensitivity and 77%specificity, considering blood culture as gold standard method. Conclusion: CRP is a rapid tool for screening of neonatal septicaemia and a reliable marker in the absence of positive blood cultures. The use of both CRP and blood culture in combination would increase the yield of laboratory confirmed neonatal septicaemia cases.
References
Borna H, Borna S. (2004) Value of laboratory tests and C- reactive protein in the detection of neonatal sepsis. Internet J of pediatrics and neonatology 5:1-6.
Gandhi TN, Patel MG, Jain MR, Saxena RB, Bhuva PJ.(2012) Utility of C reactive protein as inflammatory marker in early diagnosis of neonatal septicaemia:A cross sectional study. National J Med Res 2:481-483.
Rassol AL- Musawi KH, Kalaf DK, Karim LA. (2013) The bacterial profile and C-reactive protein of suspected septic neonates admitted to the Al- Kadyemia teaching hospital. Int J Recent Sci Res 4:1723-1727.
Ng PC. (2004) Diagnostic markers of infection in neonates. Arch Dis Child Fetal Neonatal 89:229–235. [View in PubMed]
Bang AT, Bang RA, Baitule SB, Reddy HM, Deshmukh MD. (1999) Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet 354:1955-1961. [View in PubMed]
Stoll BJ. (1997) The global impact of neonatal infection. Ciln Perinatol 24:1-21. [View in PubMed]
Karunakaran RN, Raja S, Ng KP, Navaratnam P. (2007) Etiology of blood culture isolates among patients in a multidisciplinary teaching hospital in Kuala Lumpur. J Microbiol Immunol Infect 40:432-437.
Buttery JP. (2002) Blood cultures in newborns and children: optimizing an everyday test. Arch Dis Child Fetal Neonatal Ed 87:25–28.
Roy I, Jain A, Kumar M, Agarwal SK. (2002) Bacteriology of neonatal septicaemia in a tertiary care hospital of northern India.Indian J Med Microbiol 20:156-159. [View in PubMed]
Martin TC, Adamson J, Dickson T, Digiantomasso E, Nesbitt C. (2007) Does group B streptococcal infection contribute significantly to neonatal sepsis in Antigua and Barbuda? W Indian Med J 56:1-5.
Aletayeb SMH, Khosravi AD, Dehdashtian M, Kompani F, Mortazavi SM and Aramesh MR. (2011) Identification of bacterial agents and antimicrobial susceptibility of neonatal sepsis: A 54-month study in a tertiary hospital. Afr J Microbiol Res 5:528-531.
Bansal S, Jain A, Aggarwal J, Malik GK. (2004) Significance of coagulase negative staphylococci in neonates with late onset septicema. Indian J Pathol Microbiol 47:568-586. [View in PubMed]
Agnihotri N, Kaistha N, Gupta V. (2004) Antimicrobial susceptibility of isolates from neonatal septicemia. Jpn J Infect Dis 57:273-275. [View in PubMed]
Murty DS, Gyaneshwari M. (2007) Blood cultures in pediatric patients: a study of clinical impact. Indian J Med Microbiol 25:220-224. [View in PubMed]
Tallur SS, Kasturi AV, Nadgir SD, Krishna BVS. (2000)Clinico-bacteriological study of neonatal septicemia in Hubli. Indian J Pediatr 67:169-174.
Marwah P, Chawla D, Chander J, Guglani V, Marwah A.(2015) Bacteriological profile of neonatal sepsis in a tertiary care hospital of Northern India. Indian Pediatr 52:158-159. [View in PubMed]
Sundaram V, Kumar P, Dutta S, Mukhopadhyay K, Ray P, Gautam V et al. (2009) Blood culture confirmed bacterial sepsis in neonates in North Indian tertiary care centre: changes over the last decade. Jpn J Infect Dis 62:46-50.
Maheshwari A, Dutta S, Kumar P, Narang A. (2001) Early onset mixed Morganella and Klebsiella sepsis in a neonate. Indian J Pediatr 68:671-672. [View in PubMed]
Lakshmi KS, Jayashree M, Singhi S, Ray P.(2007) Study of Nosocomial primary blood stream infections in a pediatric intensive care unit. J Trop Pediatr 53:87-92. [View in PubMed]
Jiang JH, Chiu NC, Huang FY et al. (2004) Neonatal sepsis in the neonatal intensive care unit: characteristics of early versus late onset. J Microbiol Immunol Infect 37:301-306. [View in PubMed]
Gladstone IM, Ehrenkranz RA, Edberg SC, Baltimore RS. (1990) A ten-year review of neonatal sepsis and comparison with the previous fifty-year experience. Pediatr Infect Dis J 9:819-822. [View in PubMed]
Mustafa M, Ahmed SL. (2014) Bacteriological profile and antibiotic susceptibility pattern in neonatal septicemia in view of emerging drug resistance. J Med Allied Sci 4:02-08.
Jyothi P, Basavaraj MC, Basavaraj PV. (2013) Bacteriological profile of neonatal septicemia and antimicrobial susceptibility pattern of the isolates. J Nat Sci Biol Med 4:306-309. [View in PubMed]
Shirazi H, Riaz S, Tahir R. Role of the hematological profile in early diagnosis of neonatal sepsis. (2010) Ann Pak Inst Med Sci 6:152-156.
Ayazi P, Mahyar A, Daneshi MM, Jahanihashemi H, Esmailzadehha N, Mosaferirad N. Comparison of serum IL-1 beta and C reactive protein levels in early diagnosis and management of neonatal sepsis.(2014) Le Infezioni in Medicina 4: 296-301. [View in PubMed]
De A, Saraswathi K, Gogate A, Raghavan K. (1998) C - reactive protein and Buffy coat smear in early diagnosis of childhood septicemia. Indian J Pathol Microbiol 41: 23-26. [View in PubMed]
Jha BK, Singh YI, Mahadevmurthy S. et al. (2011) Septicemia detection by blood buffy coat smear in primary healthcare centers. J College Med Sci – Nepal 7(1):19-23.
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