Volume : 5, Issue : 8, August - 2016

Evaluation of Biomarkers in the diagnosis of Neonatal Sepsis

Dr. Radhamohan Rana, Dr. Rohit Bhandar, Dr. Sharangouda Patil, Dr. Dimple Mehrotra

Abstract :

<p>&nbsp;INTRODUCTION:- Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. It encompasses various systemic infections of the newborn such as septicemia, meningitis, pneumonia, arthritis, osteomyelitis and urinary tract infections. Superficial infections like conjunctivitis and oral thrush are not usually included under neonatal sepsis. Neonatal sepsis is a worldwide problem that presents a management challenge to care groups for neonates and infants. OBJECTIVE:-To compare the role of Procalcitonin, CRP, TLC, ANC, Band forms count, I/T ratio, Toxic Granules, Thrombocytopenia and microESR in diagnosis of neonatal sepsis. DESIGN:- Prospective study SETTING:- Neonates meeting the Inclusion Criteria of our study were admitted to NICUs of Mahadevappa Rampure Medical College, Kalaburagi, from December 2013- May2015 PARTICIPANTS/PATIENTS:- 85 neonates were included in the study based on the following inclusion criteria. 1) Neonates born to mothers with at least one of the following features:- PROM &gt; 18 hours, &gt;3 vaginal examinations, maternal fever (&gt; 38&deg; C) since one week before delivery, foul smelling liquor, meconium stained liquor, untreated or partially treated urinary tract infection and prolonged and difficult delivery with instrumentation 2) Neonates admitted with signs suggestive of sepsis as per IMCI guidelines or those who developed signs of sepsis during their stay in the hospital. RESULTS:- Of the 85 neonates studied, 32 were diagnosed as proven sepsis, 34 as probable sepsis and 19 as no sepsis. The most common organism isolated on blood culture was Staphylococcus aureus. TLC, ANC, Band Count, I:T, microESR, Thrombocytopenia, Toxic granules showed low sensitivity (6%, 6.2%, 34.3%, 28.1%, 28.1%, 56.2% and 28.1%) and moderate to high specificity (96.2%, 96.2%, 88.6%, 64.1%, 98.1%, 84.9% and 62.2%), whereas CRP and PCT had high sensitivity (90.6%, 90.6%), moderate specificity (69.8%, 83%) and moderate accuracy (77.6%, 85.8%). CONCLUSION:- Procalcitonin (&gt;2ng/ml) with higher accuracy (85.8%) appears to be a better test for diagnosis of neonatal sepsis.</p>