Biochemical and immunological markers for the early diagnosis of neonatal septicaemia

Abstract

Background: Neonatal sepsis is a life-threatening condition with high mortality and morbidity throughout the world. Objective: This study evaluated the diagnostic role of serum procalcitonin (PCT), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) in the early diagnosis of neonatal sepsis. Methods: This cross-sectional study was conducted among neonates admitted to the special baby care unit (SCABU) of BIRDEM General Hospital, Dhaka, from November 2018 to April 2019. According to selection criteria, 90 clinically suspected cases of neonatal sepsis were selected and categorised into confirmed, probable, and no sepsis groups based on CRP, white cell count, platelet count, and blood culture results. Serum PCT, IL-6, and tumor necrosis factor (TNF-α) were estimated in all cases by standard laboratory methods. Results: Serum PCT, IL-6, CRP, and TNF-α were significantly higher in confirmed and probable sepsis groups in comparison to no sepsis group. Among the studied biomarkers, serum PCT was found most sensitive (95% sensitivity), and serum IL-6 was found most specific biomarkers (65.7% specificity) than CRP and TNF-α for the diagnosis of neonatal septicaemia. Though the accuracy of both PCT and IL-6 was found equal (70%), but the positive predictive value (PPV) and negative predictive value (NPV) of serum PCT were higher than IL-6. Conclusion: Both serum PCT and IL-6 are more sensitive and specific markers than CRP and TNF-α in the diagnosis of neonatal sepsis. Moreover, serum PCT is more useful than IL-6.