Diagnostic and predictive values of serum procalcitonin in comparison with routine sepsis work up in neonatal sepsis

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Author: 
Anand Manjunath K, Ramesh Samikannu, Muruganantham Balagurunathan and Praveen Kumar R

Neonatal sepsis is one of the commonest causes of morbidity and mortality in the neonates in India compared to the developed countries. It is one of the four leading causes of morbidity and mortality in India among the neonates due to delivery and postnatal follow up in an unhealthy environment and low socio-economic state leading to maternal infection and premature delivery. It is absolutely necessary to diagnose early neonatal sepsis and its cause using clinical signs and rapid diagnostic method so that no time is wasted to start the appropriate treatment.

Methodology: The prospective study was conducted in Department of Pediatrics, Rajah Muthiah Medical College Hospital, Annamalai University over a period of one year from October 2014 to October 2015. The blood samples from 100 babies meeting the inclusion and exclusion criteria constituted the material for study. Detail history and clinical findings were recorded in the proforma. Blood sample will be collected from the neonate and will be sent for: Procalcitonin levels, CRP levels, Blood culture and sensitivity, Total count, absolute neutrophil count and band cell ratio.

Results: This is a prospective study conducted over a period of one year from October 2014 to October 2015.100 babies were included in the study. Males were 57 (57%) and females were 43 (43%). 28 cases were < 2.5 kgs and 72 babies are >2.5 kgs. Procalcitonin is positive in 34 (34%) and negative in 66 (66%). CRP was positive in 22 (22%) and negative in 78 (78%). 91 (91%) of cases had blood culture negative and in 9 (9%) cases blood culture was positive. Total count < 5000 was noted in 10 (10%) of patients and in the remaining 90 (90%) was > 5000. Absolute neutrophil count < 1000 was not observed in any of the cases and all the cases it was >1000. There was no sepsis observed in 67 (67%) of cases, probable sepsis was observed in 24 (24%) of cases and definite sepsis was observed in 9 (9%). Procalcitonin in comparison with CRP, sensitivity was 100%, specificity was 84.6%, PPV was 64.7%, and NPV was 100%

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