Title: Role of C-Reactive Proteins as a Diagnostic & Prognostic Indicator In Neonatal Sepsis
Authors: Dr S.K.Valinjkar, Dr Shruti.Dhale, Dr Sunil S. Sarode
DOI: http://dx.doi.org/10.18535/jmscr/v4i4.36
Abstract
Aims and objectives 1) To assess role of CRP as a promising marker in diagnosis of neonatal sepsis.
2) To determine the utility of CRP as a prognostic indicator in neonatal sepsis.
Study Design: This was an observational study which was conducted in a tertiary care center in a metropolitan city over a period of 2 years
Materials and methods: Neonates admitted with clinical signs & symptoms suggestive of neonatal sepsis was studied. Detection of CRP in human serum was done by therapid slide latex agglutination qualitative method supplied commercially by Span Diagnostics Ltd. with cut off value of CRP being 6mg/dl.
Results: In this study of 200 neonates with signs and symptoms of neonatal sepsis 69.50% had positive CRP &30.50% have negative CRP on day 1 of admission. These cases were followed subsequently with starting of empirical antibiotics therapy and CRP repeated on day 5 and day 10 / or on discharge whichever is earlier. It showed that CRP positivity decreased over this periods to 9%.Negative predictive value of SERIAL CRP increases from 35% on day 1 to 94% on day 10 / or on discharge, which signifies that serial CRP value rules out sepsis with high accuracy and helpful in deciding duration of antibiotics in neonatal sepsis. Sensitivity of SERIAL CRP increases from 31% on day 1 to 53% on day10 / or on discharge which is significant. Mean duration of antibiotics on the basis of serial CRP values in neonates with signs and symptoms suggestive of sepsis is reduced from 14 days in non-study group to 9 days (approximately 40 % reduction in duration of antibiotics treatment) with p value<0.003,which is significant.
Conclusion: CRP is the rapid diagnostic test which has high sensitivity and negative predictive values in diagnosis of neonatal sepsis.CRP can be used as screening test for early diagnosis as well as deciding duration of antibiotics in neonatal sepsis.
Keywords: Sepsis, Serial CRP levels, Duration of antibiotic therapy.
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