Diagnostic Performance of Various Laboratory Parameters for Neonatal Sepsis in a Tertiary Care Hospital

Abstract

Background: Infections commonly cause morbidity and mortality in neonates despite various advances. It accounts for more than a million annual deaths worldwide, more cases from the developing countries have been reported. Around 2% of the fetuses worldwide acquire in utero infection, whereas 10% fetuses get infected in the first month. Introduction: Sepsis is rampant in our socioeconomic conditions. Any infection in the neonate can be fatal. It is a challenge for all the health care providers worldwide to reduce the morbidity & mortality caused by neonatal sepsis by a timely diagnosis and appropriate intervention. Early diagnosis of neonatal septicemia helps the clinician in instituting antibiotics therapy at the earliest during its progressive course thereby reducing morbidity and mortality in neonates and also helps in avoiding unnecessary treatment of a non-infected neonate. In the present study an attempt has been made to study the biochemical profile of neonatal sepsis and in evaluation of various biochemical markers to diagnose presence of septicemia. Methods: This study included 100 neonates presenting to a tertiary care NICU for presence of sepsis. After examining for risk factors and systemic illness, intravenous sampling was done for screening of sepsis after written informed consent. Diagnostic performance of various laboratory parameters involved was calculated after evaluating their statistical significance. Results: All the routine markers are found to be highly specific in diagnosis of neonatal sepsis. The specificity of TLC, ANC, I/T RATIO, MICRO ESR and CRP was found out to be 87.8%, 79.7% 77% 85.1% and 83.7% respectively. MICRO ESR and CRP show a better sensitivity and positive predictive value than other markers in addition to high specificity and negative predictive value. CRP is found to have better sensitivity (73.1%), positive predictive value (61.3%) and negative predictive value (90%) than other used routine markers. Conclusion: .