Neonatal Sepsis: Diagnostic Challenges and the Role of CRP and Blood Culture

• Saurabh Chhotalal Norris,  
• Rachana Dhirubhai Patel,  
• Himani Bhardwaj Pandya,  
• Binda Prakashbhai Pipaliya,*  
• Tanuja Bakul Javadekar

Abstract

Background: Neonatal septicemia, a serious blood infection occurring within the first four weeks of life, is a significant cause of neonatal deaths. Its diagnosis is challenging due to the non-specific nature of its signs and symptoms. C-reactive protein (CRP) serves as a valuable biomarker for early detection, facilitating timely treatment and improving survival rates as a rapid adjunct to the standard blood culture process. This study explores the relationship between CRP levels and blood culture findings in diagnosing Neonatal septicemia. Aim and Objectives: The objectives were to determine common organisms causing neonatal septicemia, to evaluate CRP as a diagnostic tool for Neonatal septicemia compared to blood culture results. Materials and Methods: The study examined the correlation between CRP levels and blood culture outcomes in neonates suspected of having sepsis. Blood samples were aseptically collected and inoculated in 1 set of BD BACTECTM Peds Plus/F blood culture bottles, incubated for five days using a BD BACTEC automated machine. The bacteria isolated from positive blood culture were processed using Vitek-2. CRP levels were determined using the latex agglutination card test, with positive samples further analyzed via quantitative nephelometry. Results: Of the 321 samples, 28.97% (93) tested positive for bacterial sepsis via blood culture. Among these, 33.3% (31 cases) were Staphylococcus epidermidis, 18.3% (17 cases) were Staphylococcus haemolyticus, and 11.8% (11 cases) were Staphylococcus capitis, with coagulase-negative staphylococci (CONS) being the most common group overall. Among the Gram-negative organisms, Klebsiella pneumoniae (8.6%) and E. coli (6.5%) were significant contributors to neonatal septicemia. CRP was positive in 82 cases with blood culture-positive samples and in 105 cases with blood culture-negative samples, underscoring its potential as a diagnostic marker for Neonatal septicemia. Conclusion: While CRP is a valuable biomarker for detection of Neonatal septicemia, it should not be used as a sole diagnostic tool due to its lack of specificity. CRP testing provides a presumptive diagnosis that can guide early antibiotic therapy, emphasizing its significance in neonatal care.

Keywords

C-reactive protein (CRP), Neonatal sepsis, Blood culture