A Clinical Study on the Diagnostic Significance of Sepsis Markers in Neonatal Sepsis in a Tertiary Care Center
Background: In neonatal period after prematurity, sepsis is considered as the second leading cause of mortality. Aims & Objective: To know the sensitivity, specificity, positive predictive value and negative predictive value of sepsis markers in a neonate. Materials & Methods: All babies< 28 days of life with sepsis risk factors, and clinical features suggesting sepsis were included in this study. Results: A total of 100 neonates admitted to NICU were enrolled in the study. 32% of the cases had abnormal WBC levels, 44% of cases had thrombocytopenia and CRP was positive in 89% of the cases.18% of the cases had culture-proven sepsis, 29% cases had probable sepsis and 53% cases had suspected sepsis. Total leucocyte count had a moderate Negative predictive value (62.5%), low Sensitivity (33.3%), low Specificity (24.4%), and low Positive predictive value (8.8%) in detecting sepsis. Platelets had a high negative predictive value (91.1%), moderate sensitivity (72.2%), moderate specificity (62.2%), and low positive predictive value (29.5%). In detecting sepsis CRP levels had high Sensitivity (83.3%), and moderate Negative predictive value (72.7%) with low Specificity (9.8%), and low positive predictive value (16.9%). In diagnosing culture-proven sepsis high sensitivity was observed by increased CRP levels(83.3%), moderate Sensitivity by thrombocytopenia (72.2%), moderate Specificity by thrombocytopenia (62.2%), high Negative predictive value by thrombocytopenia (91.1%), moderate Negative predictive value by CRP levels (72.7%), and leucopenia (62.5%). Conclusions: No single individual test is better than others in detecting neonatal sepsis. The conjunction of tests like Total WBC, Platelets, and CRP are to be utilized for better sepsis screening.
