Role of Complete Blood Count and C – Reactive Protein as Diagnostic Markers in Sepsis In Neonatal Intensive Care Unit Patients
Role of complete blood count and C – reactive protein as diagnostic markers
Keywords:
CBC, HS CRP, NICUAbstract
Background: Neonatal Intensive care unit is complex components of health care. Severe sepsis mortality ranges from 28% to 50%. Markers of inflammation, as C- reactive protein, erythrocyte sedimentation rate and complete blood counts are still useful investigations for sepsis in NICU. Research Objective: To access and analyse correlation between CBC and CRP concentration among NICU patients and to NICU outcome and its relationship with the diagnosis. Methodology: This cross-sectional study was carried on 327 patients admitted in NICU at C. U. Shah medical college and hospital. From time of admission to discharge day, signs and symptoms, clinical and laboratory data regarding CBC and CRP levels collected with other relevant tests according to the patient's clinical status. Results: In 92.92 % of all NICU patients with sepsis, CRP was >30 mg/L. Of all NICU patients with sepsis, leucocytosis, thrombocytopenia and raised absolute neutrophil count was observed in 66.13%, 13.53% and 56.8% respectively. Conclusion: Leukocytosis and neutrophilia are predictive of sepsis. CRP value greater than 30.0 mg/L is 90 percent sensitive and sequential assessment of CRP values is specific for diagnosis of sepsis. If the CRP level remains persistently normal, bacterial sepsis is unlikely.[Shivani TNJIRM 2017; 8(2):1-4]
References
2. Bizzarro MJ, Dembry LM, Baltimore RS, Gallagher PG. Changing patterns in neonatal Escherichia coli sepsis and ampicillin resistance in the era of intrapartum antibiotic prophylaxis. Paediatrics 2008; 121:689
3. Committee on Infectious Disease American Academy of Pediatrics. Group B Streptococcal Infections. In: Red Book: 2012 Report of the Committee on Infectious Diseases, 29th ed, Pickering LK, Baker CJ (Eds), American Academy of Pediatrics, Elk Grove Village 2012. p.680
4. Nizet V, Klein JO. Bacterial sepsis and meningitis. In: Infectious diseases of the Fetus and Newborn Infant, 7th ed, Remington JS, et al (Eds), Elsevier Saunders, Philadelphia 2010. p.222.
5. Polin RA, Committee on Fetus and Newborn. Management of neonates with suspected or proven early - onset bacterial sepsis. Paediatrics 2012; 129:1006.
6. Ehl S, Gering B, Bartmann P, et al. C- reactive protein is a useful marker for guiding duration of antibiotic therapy in suspected neonatal bacterial infection. Paediatrics 1997; 99: 216
7. Murray BE. Can antibiotic resistance be controlled? The New England Journal of Medicine. 1994; 330(17):1229-30.
8. Newman TB, Puopolo KM, Wi S, et al. Interpreting complete blood counts soon after birth in newborns at risk of sepsis. Paediatrics 2010; 126:903
9. Hornik CP, Benjamin DK, Becker KC, et al. Use of complete blood cell count in early onset neonatal sepsis. Paediatr Infect Dis J 2012; 31:799.
10. Hornik CP, Benjamin DK, Becker KC, et al. Use of complete blood cell count in late onset neonatal sepsis. Paediatr Infect Dis J 2012; 31:803.
11. Kääpä P, Koistinen E. Maternal and neonatal C-reactive protein after interventions during delivery. ActaObstetriciaEtGynecologicaScandinavica. 1993; 72(7):543-6
12. Pourcyrous M, Bada HS, Korones SB, Baselski V, Wong SP. Significance of serial C reactive protein responses in neonatal infection and other disorders. Paediatrics. 1993; 92(3):431-5
