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COMPARISON BETWEEN PROCALCITONIN AND C-REACTIVE PROTEIN AS A SENSITIVE MARKER OF EARLY ONSET SEPSIS AMONG SAUDI NEONATES

Background & objectives: Early diagnosis of neonatal sepsis (NS) is difficult because of the variable and non-specific clinical presentation. Also, many laboratory tests are negative at the early stage of diseases, so the study aimed to detect the role of procalcitonin (PCT) in early detection of NS versus to C-reactive protein (CRP) and other hematological parameters. Methods: A cross-sectional study was conducted on 150 newborn babies with signs suggesting sepsis admitted to neonatal intensive care units (NICU) at 2 (As-Salama and Alawi Tunsi) hospitals in KSA. Laboratory tests including PCT, CRP, complete blood count (CBC), erythrocyte sedimentation rate (ESR) and blood cultures were done for all cases. Results: Based on clinical findings and laboratory data; 28%, 32% and 40% of patients were categorized as culture proven sepsis, suspected sepsis and clinical sepsis respectively. PCT was positive in 92.9%, 58.3% and 3.3% compared to CRP positivity in 50%, 43.8% and 20% of patients with proven sepsis, suspected sepsis and clinical sepsis respectively. PCT sensitivity, specificity, positive predictive value and negative predictive value were 92.8%, 72.2%, 59% and 96% respectively while CRP results were 50%, 69.4%, 38.8% and 78.1% respectively. Serum values of PCT and CRP differed significantly in the 3 sepsis groups indicating relation to the severity of sepsis. Altered hematological parameters founded only in 14.3% of proven sepsis cases. Conclusions: Serum PCT level was superior to serum CRP level in terms of early diagnosis of NS and in detecting the severity of illness. and altered hematological parameters have a minor role for early detection of sepsis.