The Comparison of Diagnostic Value of Serum Procalcitonin and C - reactive Protein in Neonates with Sepsis

Background: Infantile sepsis is one of the most important cause of morbidity and mortality around the world so that early diagnosis and treatment is mandatory. C-reactive protein (CRP) and procalcitonin (PCT) is two important markers for early diagnosis of sepsis. About 6-8 hours after confrontation with inflammation or tissue damage, CRP will be produced from hepatocytes. Level of procalcitonin in serum starts to increase 2-4 hours after bacterial endotoxin releasion that can reach on pick up to 6-8 hours later. The goal of this project is to compare the diagnostic value of these two markers in neonatal sepsis.Material and Method: All the neonates with the impression of sepsis who were admitted in neonatal ward of Nemazee hospital from Aug 2016 to Aug 2017 were come into the study. The exclusion criteria were administration of antibiotic therapy prior to admission. WBC, CRP and procalcitonin were checked in these patients and all data were analyzed using SPSS.Results: The number of neonates who were analyzed was 102 that 32 were female and 70 were male. The mean of their weight was 2892.16 gr. Half of the cases were born by Natural Vaginal Delivery and half by Cesarean Section. The mean of WBC, CRP and PCT respectively were 11.346 cell/microliter, 23.94 mg/l and 3.64 mcg/l. In the setting of definite sepsis which means that the patients had positive blood culture, sensitivity and specificity of CRP were 39.47% and 73.43% while these percent were 37.50% and 71.42% for PCT. Positive and negative predictive value were 46.87% and 67.14% for CRP and 37.50% and 71.42% for PCT. Conclusion: In this study sensitivity of CRP and procalcitonin were under 50% and specificity was under 75% which means that we cannot detected all neonates with sepsis just with CRP or PCT.

Keywords:

Procalcitonin , specificity , sensitivity , sepsis , CRP