Accuracy of C-reactive protein (CRP) and hematological indices as a screening tool in neonatal bacterial sepsis

Zainab Farhan, Pediatric Department, Al-Karkh Maternity Hospital, Baghdad, Iraq.Follow
kassim Rahi, Pediatric Department, Central Child Teaching Hospital, Baghdad, Iraq.Follow

Article Type

Original Study

Abstract

Background: Early recognition of neonatal sepsis is challenging due to its subtle and nonspecific symptoms. Failure to recognize or delays in diagnosis can result in significant mortality and morbidity. Laboratory sepsis markers complement clinical signs and risk factors in diagnosing sepsis. The current approach for early recognition of sepsis combines clinical presentation, biomarkers, and blood culture. Aims: This study aims to assess the effectiveness of C-reactive protein and basic hematological indices, such as neutropenia, leukopenia, and thrombocytopenia, in diagnosing sepsis, measuring the sensitivity of each test, and evaluating the outcomes of the studied sample. Methods: This study consisted of 90 patients with clinical suspicion of sepsis who were admitted to the neonatal care unit at Central Child Teaching Hospital in Baghdad. Patients were classified according to the age at which symptoms began into early onset and late onset sepsis. All patients underwent blood culture and sensitivity testing, complete blood count, and serial C-reactive protein measurements. Results: late onset sepsis was more common than early onset sepsis, and males outnumbered females. The sensitivity of C-reactive protein was 84%, with a specificity of 13%. The positive predictive value (PPV) and negative predictive value (NPV) were 21% and 75%, respectively. Total leukocyte count (TLC) demonstrated a sensitivity of 42%, specificity of 77%, PPV of 33%, and NPV of 83%. Absolute neutrophil count (ANC) showed a sensitivity of 5%, specificity of 97%, PPV of 33%, and NPV of 79%. Thrombocytopenia exhibited a sensitivity of 32%, specificity of 85%, PPV of 35%, and NPV of 82%. Conclusion: C-reactive protein had the highest sensitivity, while ANC had the highest specificity. Complete blood count showed little correlation with sepsis, and thrombocytopenia was a late finding associated with increased mortality. All tests utilizing the hematological profile can be employed using hematological profile can be used on primary health center level, with results obtainable within hours.

Keywords

C-reactive protein, neonatal sepsis, blood culture, hematological parameters

Recommended Citation

Farhan, Zainab and Rahi, kassim (2025) "Accuracy of C-reactive protein (CRP) and hematological indices as a screening tool in neonatal bacterial sepsis," Iraqi National Journal of Medicine: Vol. 7 : Iss. 1 , Article 5.
Available at: https://doi.org/10.37319/iqnjm.7.1.14