Background: Early detection and start of antibiotic therapy neonatal sepsis (N.S) dramatically
improves outcomes, so it is important to perform fast, reliable and specific early laboratory
biomarkers.
Aim: This study aimed to detect the prevelance, the risk factors, hematology profile, microbial profile
of neonatal sepsis patients and also investigate the value of PCT and CRP, in comparison to
presepsin in establishing the early diagnosis of neonatal sepsis.
Methods: A cross sectional study was performed from March to September 2019 in Al Quwayiyah
General hospital involving 120 neonates who were classified into 3 groups. The patients groups
Original Research Article
Khater and Al-Hosiny; JAMB, 20(1): 80-90, 2020; Article no.JAMB.54569
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were: Proved N.S, suspected N.S and control healthy neonates, classified depending on Tollner
score. Haematology profile and blood culture for each neonate were done. CRP, PCT and presepsin
values were analyzed, compared, and their effectiveness as diagnostic markers was determined.
Sensitivity, specificity, positive, and negative predictive values of the markers were calculated.
Results: The prevelance of neonatal sepsis was 20.8%. 75 neonates were males and 45 neonates
were females. 74 neonates were preterm, while 46 were full term. Gestational age in weeks was
31.1±5.9w for neonates with proved sepsis, 32.4±6.7w for neonates with suspected sepsis and
36.4±4.4w for control group. The mean birth weight was 1740±105.3 g for neonates with proved
sepsis, 32.4±6.7 g for neonates with suspected sepsis, 2.650±205.2 g for control group. 36 babies
suffered from respiratory distress syndrome, 10 had jaundice, 8 had cough, 28 had fever and 8
complained of other symptoms. Blood cultures were positive for all patients of proved sepsis. The
identified bacteria included Gram positive bacteria 22(55%) which were Coagulase negative staph.
13(32.5%) followed by Staphylococcus aureus 4(10%) while Gram negative bacteria 15(37.5%)
which were E. coli 5(12.5%) followed by Klebsiella peumoniae and also fungal infection (Candida
species) detected in 3(7.5%) cases. There was significant difference between the mean and
standared deviation of CRP, PCT and presepsin levels in proved and suspected N.S. groups when
compared with healthy controls (P< 0.05). CRP sensitivity and specificity (72%, 61% respectively)
which were less useful in diagnosis of neonatal sepsis compared to presepsin which has the highest
sensitivity and specificity (95%, 81% respectively) followed by procalcitonin with sensitivity and
specificity (90%, 69% respectively).
Conclusion: The prevalence of neonatal sepsis among all admitted neonates in Al-Quwayiyah
general hospital was 20.8%. Our results also detected higher sensitivity, specificity and positive and
negative predictive values for presepsin more than and PCT CRP in the diagnosis of NS. |
