Study to correlate sepsis markers and blood culture in neonatal sepsis

Authors

  • Harshitha M. Swamy Department of Paediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Lakshmi . Department of Paediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Mallesh K. Department of Paediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Asima Banu Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20200043

Keywords:

Blood culture, Diagnosis of sepsis, Neonatal sepsis, Sepsis markers

Abstract

Background: Neonatal sepsis forms the second most common cause of neonatal mortality resulting in more than one million neonatal deaths per year. Neonatal sepsis, pneumonia and meningitis together result in one- fourth of all newborn deaths. Objectives of the study was to correlate sepsis markers with blood culture in neonatal sepsis.

Methods: A cross sectional study was carried out in the NICU unit under department of Pediatrics, between November 2017 and May 2019. Sample size was 50. Babies admitted to NICU with clinical suspicion of sepsis were included in the study. Blood samples from these babies were collected under aseptic precautions and subjected to rapid diagnostic tests- sepsis markers and blood culture.

Results: Male were predominant (64%). Important risk factors were preterm and low birth weight. Blood culture positivity was 20% (E. coli being most commonly isolated organism). CRP had a high sensitivity of 90% and low specificity of 47%. Procalcitonin had highest sensitivity of 100% and low specificity of 47.5%.

Conclusions: CRP and PCT were found to be statistically significant (p=0.036 and 0.01), can be used as a diagnostic tool in neonatal sepsis.

References

Murthy S, Godinho MA, Guddattu V, Lewis LE, Nair NS. Risk factors of neonatal sepsis in India: A systematic review and meta-analysis. PloS one. 2019 Apr 25;14(4):e0215683.

Woldu MA, Guta MB, Lenjisa JL, Tegegne GT, Tesafye G, Dinsa H. Assessment of the incidence of neonatal sepsis, its risk factors, antimicrobial use and clinical outcomes in Bishoftu General Hospital. Neonatal Intensive Care Unit, Debrezeit-Ethiopia. Pediat Therapeut. 2014 Aug;4(214):2161-0665.

Sonawane VB, Mehkarkar N, Gaikwad S, Kadam N. Comparison between sepsis markers and blood culture in diagnosis of neonatal sepsis: a prospective study. Inter J Res Med Sci. 2017 Mar 28;5(4):1662-6.

Chiesa C, Panero A, Osborn JF, Simonetti AF, Pacifico L. Diagnosis of neonatal sepsis: a clinical and laboratory challenge. Clini Chem. 2004 Feb 1;50(2):279-87.

Dhanalakshmi V, Sivakumar ES. Comparative Study in Early Neonates with Septicemia by Blood Culture, Staining Techniques and C–Reactive Protein (CRP). J Clini Diagnostic Res: JCDR. 2015 Mar;9(3):DC12.

Khinchi Y, Kumar A, Yadav S. Profile of Neonatal sepsis. JCMSN. 2019 Nov;6(2):1-6

Hassan HR, Gohil JR, Desai R, Mehta RR, Chaudhary VP. Correlation of blood culture results with the sepsis score and sepsis screen in the diagnosis of early-onset neonatal septicemia. J Clini Neonatol. 2016 Jul 1;5(3):193-8.

El-Din EMRS, El-Sokkary MMA, Bassiouny MR Hassan R. Epidemiology of Neonatal Sepsis and Implicated Pathogens: A Study from Egypt. Biomed Res. Int. 2015;509484

Zakariya BP, Bhat V, Harish BN, Babu TA, Joseph NM. Neonatal sepsis in a tertiary care hospital in South India: bacteriological profile and antibiotic sensitivity pattern. Ind J Pediatr. 2011 Apr 1;78(4):413-7.

Verma P, Berwal PK, Nagaraj N, Swami S, Jivaji P, Narayan S. Neonatal sepsis: epidemiology, clinical spectrum, recent antimicrobial agents and their antibiotic susceptibility pattern. Int J Contemp Pediatr. 2015 Jul;2(3):176-80.

Escobar GJ, Li DK, Armstrong MA, Gardner MN, Folck BF, Verdi JE, et al. Neonatal sepsis workups in infants≥ 2000 grams at birth: a population-based study. Pediatr. 2000 Aug 1;106(2):256-63.

Kabwe M, Tembo J, Chilukutu L, Chilufya M, Ngulube F, Lukwesa C, et al. Etiology, antibiotic resistance and risk factors for neonatal sepsis in a large referral center in Zambia. Pediatr Infect Dis J. 2016 Jul 1;35(7):e191-8.

Madavi D, Aziz F, Agrawal G. Clinico-bacteriological profile and antibiotic sensitivity pattern of neonatal septicaemia- a prospective observational study. Int J Cur Res Rev. 2015 Mar;7(5):13-20.

Jiang JH, Chiu NC, Huang FY, Kao HA, Hsu CH, Hung HY, et al. Neonatal sepsis in the neonatal intensive care unit: characteristics of early versus late onset. J Microbiol, Immunol Infect. 2004 Oct;37(5):301-6.

Agarwal R, Sankar J. Characterisation and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centres in Delhi, India: a cohort study. Lancet Global Health. 2016;4(10):e752-60.

Galhotra S, Gupta V, Chhina D, Bains HS, Chhabra A. Comparative utility of C reactive protein and Blood culture for diagnosis of neonatal septicaemia. Inter J Res. 2017 Dec;6(2):2586-9.

Flidel‐Rimon O, Galstyan S, Juster‐Reicher A, Rozin I, Shinwell ES. Limitations of the risk factor based approach in early neonatal sepsis evaluations. Acta paediatr. 2012 Dec;101(12):e540-4.

Kocabas E, Sarikcioglu A, Aksaray N, Seydaoglu G, Seyhun Y, Yaman A. Role of procalcitonin, C-reactive protein, interleukin-6, interleukin-8 and tumor necrosis factor-alpha in the diagnosis of neonatal sepsis. Turk J Pediatr. 2007 Jan 1;49(1):7-20.

Downloads

Published

2020-01-23

Issue

Section

Original Research Articles