Procalcitonin and C- Reactive Protein as Diagnostic Markers of Neonatal Sepsis

Neonatal sepsis is a serious problem associated with significant neonatal morbidity and mortality. Diagnosis of neonatal sepsis may be difficult because the clinical presentations are often non-specific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. This study aimed to evaluate procalcitonin (PCT) and C-reactive protein (CRP) as diagnostic markers of neonatal sepsis. Sixty neonates with suspected neonatal sepsis were recruited from the neonatal intensive care unit (NICU), Sohag university hospital, Egypt. They were allocated into two groups; early-onset neonatal sepsis (EONS; n=32) and late-onset neonatal sepsis (LONS; n=28). Blood samples were obtained from the participants for complete blood count (CBC), blood cultures, serum CRP and PCT analysis. Area under the receiver operating characteristic (ROC) curve (AUC), predictive values and diagnostic cut off values of CRP and PCT were evaluated. In total, 42 (70%) neonates were confirmed to have sepsis based on positive blood culture results. Serum levels of CRP and PCT were significantly higher in neonates with EONS than those with LONS (p=< 0.05). However, there was no significant statistical difference between the area under the curve (AUC) values of PCT and CRP in all studied cases, EONS or LONS cases (p=0.32, p= 0.29, p=0.28 respectively). In conclusion, PCT and CRP are reliable diagnostic markers of neonatal sepsis, which have the same diagnostic accuracy. CRP; being easily measurable and more affordable can be conveniently used as a good marker for the diagnosis of neonatal sepsis, especially in developing communities with poor resources.