COMPARING SERUM PROCALCITONIN AND SERIAL C-REACTIVE PROTEIN AS SCREENING MARKERS FOR NEONATAL BACTERIAL SEPSIS AT THE LAGOS UNIVERSITY TEACHING HOSPITAL, IDI-ARABA LAGOS, NIGERIA

COMPARING SERUM PROCALCITONIN AND SERIAL C-REACTIVE PROTEIN AS SCREENING MARKERS FOR NEONATAL BACTERIAL SEPSIS AT THE LAGOS UNIVERSITY TEACHING HOSPITAL, IDI-ARABA LAGOS, NIGERIA

Abstract

Neonatal sepsis (NNS) is a leading cause of morbidity and mortality in the developing countries
requiring early diagnosis and prompt treatment. The diagnosis of neonatal sepsis is very
challenging to the physician as the symptoms are non-specific and blood culture which is the
gold standard in the diagnosis requires a lot of blood, has a low sensitivity, is expensive and has
a long result turn out time. Screening markers like C –Reactive Protein (CRP) and Procalcitonin
(PCT) can help to make an early diagnosis thereby reducing the cost of care of the newborn with
sepsis.
The aim of the present study was to compare serial C- reactive protein and Procalcitonin as
screening markers for neonatal bacterial sepsis against blood culture which is the accepted gold
standard.
The study population was made up of neonates who were managed at the Lagos University
Teaching Hospital (LUTH) over a 6 month period. One hundred and five (105) neonates were
recruited into the study and samples for CRP, PCT and blood culture were taken from each
newborn. The CRP and PCT were analysed using point of care kits while the blood culture
samples were collected in the BACTEC culture bottles and incubated in the BACTEC 9050
machine. All samples were taken on presentation, prior to commencement of antibiotics, and
additional CRP samples were collected at 24 hours and at 72 hours. Levels of CRP and PCT
obtained were compared with blood culture results. The relationship between CRP, PCT and
specified variables: gestational age, onset time of sepsis and outcome of the treatment was
determined. Data was analysed using the Epi InfoTM 2008 version 3.4.1 software.
The sensitivity of CRP at presentation (0 hour) was 100% while at 24 hours it was 82% and
70% at 72 hours. The specificity of CRP at 0, 24 and 72 hours were 65%, 66% and 75%
respectively while the negative predictive values of CRP at 0, 24 and 72 hours were 100%, 97%
and 96% respectively.
On the other hand, PCT done on presentation had 100% sensitivity and negative predictive
values of 100%.
Blood culture was found to be positive in 11 neonates giving an overall infection rate of of
10.5%.
Both CRP and PCT were found to have significantly higher positivity rates in the term babies
compared to the preterm neonates. Both markers were also found to be more significant in late
onset sepsis.
In conclusion, PCT on the day of presentation has a high sensitivity and NPV and is useful in
early diagnosis of neonatal sepsis. However, serial CRP with high sensitivity and NPV can also
be used.

COMPARING SERUM PROCALCITONIN AND SERIAL C-REACTIVE PROTEIN AS SCREENING MARKERS FOR NEONATAL BACTERIAL SEPSIS AT THE LAGOS UNIVERSITY TEACHING HOSPITAL, IDI-ARABA LAGOS, NIGERIA

Sharing is caring!