Procalcitonin Versus C-Reactive Protein: A Comparative Study for the Diagnosis of Neonatal Sepsis

Background: Neonatal sepsis remains a major contributor to neonatal morbidity and mortality worldwide. Timely and accurate diagnosis, followed by prompt treatment, is critical for improving neonatal survival. Objective: To compare the diagnostic accuracy of procalcitonin (PCT) and C-reactive protein (CRP) in neonates with suspected sepsis. Methodology: This cross-sectional study was conducted in the Microbiology Department from March 2024 to August 2024. A total of 88 neonates (aged ≤28 days) with two or more clinical signs of sepsis were included using a non-probability convenience sampling technique. Data collected included demographic details, clinical examination findings, blood culture results, and quantitative values of PCT and CRP. Results: The mean age of neonates was 6.10 ± 2.64 days. Among them, 56 (63.6%) were males and 32 (36.4%) were females. The most frequent clinical finding was low birth weight (39, 44.3%), followed by prematurity (35, 39.8%). Using blood culture as the gold standard, PCT demonstrated higher diagnostic accuracy (55.68%) compared to CRP (37.5%). Sensitivity and specificity of PCT were 74.3% and 43.4%, respectively, while those of CRP were 56.6% and 19.3%, respectively. Positive blood cultures were found in 35 (39.8%) neonates, with Klebsiella pneumoniae being the most common organism (14, 15.9%), followed by Acinetobacter baumannii (10, 11.4%) and Escherichia coli (7, 8%). Conclusion: Procalcitonin is a more reliable biomarker than C-reactive protein for diagnosing neonatal sepsis. Its use may support earlier diagnosis and targeted interventions, potentially improving neonatal outcomes. Keywords: Acinetobacter baumannii, Blood Culture, C-Reactive Protein, Escherichia coli, Klebsiella pneumoniae, Neonatal Sepsis, Procalcitonin.