Assessment of Diagnostic Markers for Early Detection of Neonatal Sepsis: A Comparative Analysis of CRP, PCT, 16SrDNA and Blood Culture

Neonatal sepsis, a life-threatening condition, continues to be a significant global health concern. The combined occurrence rate of sepsis with positive cultures in hospital-derived records from South Asia stands at 15.8 cases per 1000 live births. The aim of this study is to compare the diagnostic performance of CRP, PCT and 16srDNA as early diagnostic markers in the detection of neonatal sepsis with blood culture. From November 2021 to October 2022, cross-sectional research on newborns hospitalized in critical care units with a clinical suspicion indicating possibility of sepsis was conducted. On day 1 of admission, blood was drawn for blood culture, C-reactive protein, procalcitonin analysis and 16SrDNA analysis. The patients were classified into two groups namely, proven and suspected sepsis based on clinical parameters and positivity in CRP, PCT and blood culture. The research involved a total of 100 patients. The majority of the research participants, were females 54(54%). Escherichia coli 6(27.2%) and Klebsiella pneumoniae 8(36.3%) were the most commonly isolated pathogens in blood culture. Low birth weight and prematurity were seen in 69(69%) and 42(42%) patients respectively. Blood culture, 16SrDNA, CRP and procalcitonin was positive in 22(22%), 35(35%), 43(43%) and 44(44%) respectively. The sensitivity is highest for PCT(72.09%) and specificity was highest for blood culture(95.52%). 16S rDNA analysis could detect proven sepsis in 35(97.2%) cases and was found to be statistically significant. 16S rDNA serves as a dependable marker for detecting neonatal sepsis. To ensure the comprehensive identification of cases, supplementary analysis of procalcitonin, in conjunction with C-reactive protein, is essential. This approach assists in avoiding the neglect of newborn sepsis cases.