The role of C-reactive protein in diagnosis of neonatal early-onset sepsis

Abstract Background: Bacterial sepsis is one of the most common diagnostic challenges in newborn medicine and is considered as a leading cause of neonatal mortality and morbidity. Objective: To study the role of C-reactive protein (CRP) in diagnosis of neonatal early-onset sepsis. Method: This was a cross-sectional analytical study in which 100 newborn babies admitted to NICU were investigated. C-reactive protein was measured before and 24 hours after the beginning of therapy. Continuation or cessation of antibiotic treatment depended upon the results of CRP and blood culture. The data were analyzed statistically using chi-square and fisher exact tests. Findings: Sensitivity of the first measurement of CRP compared with the result of blood culture was unmeasurable, but the negative predictive value was 97%. The sensitivity of CRP in second measurement and the negative predictive value were 100%. Conclusion: Our findings revealed that the first CRP result bear little sensitivity in diagnosing sepsis, however, the second CRP result produced higher sensitivity and negative predictive value (100%) for detection of early-onset sepsis. CRP negativity 24 hours after the onset of symptoms could rule out the presence of sepsis with further antibiotic cessation. On the other hand, a positive CRP with sensitivity of 100% is suggestive of sepsis.