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Alpha1-acid glycoprotein for the early diagnosis of neonatal sepsis.

OBJECTIVE
We aimed to evaluate the diagnostic value of C-reactive protein (CRP) and alpha1-acid glycoprotein (alpha1AG) in the early diagnosis of neonatal sepsis.


DESIGN
The study was prospectively conducted among newborns hospitalized for 'rule out sepsis' to neonatal intensive care unit (NICU).


SETTING AND SUBJECTS
A total of 97 children [16 with confirmed sepsis (Group I), 34 with clinical sepsis (Group II), and 47 in control group (Group III)] were enrolled in the study. On admission to NICU, blood was sampled for CRP, blood culture, and alpha1AG before starting antibiotherapy. Twenty-four hours later CRP and alpha1AG levels were detected for second tests in the study group.


RESULTS
In Group I and II, while the 1st and 2nd tests CRP levels were not different, the 2nd test alpha1AG levels were significantly higher than the 1st test results (p<0.01). Second test CRP and alpha1AG levels were also statistically higher in Group I than Group II (p<0.05).


CONCLUSION
It is shown that CRP has limited value in the early diagnosis of neonatal sepsis. A significant increase in alpha1AG levels was detected in neonatal sepsis but its high specificity was accompanied with low sensitivity. Since the 2nd test alpha1AG values resulted with high sensitivity, we suggest that serial alpha1AG tests may be used but a single test for alpha1AG has limited usefulness in the neonatal sepsis which requires rapid diagnosis.