Study of Serum Levels of CRP In Association with Blood Culture as an Early Predictor of Sepsis in Children -A Retrospective Study at A Tertiary Care Centre

Background: Septicemia remains a major cause of morbidity and mortality among children, particularly in developing countries. Early diagnosis is often challenging due to nonspecific clinical manifestations, and blood culture, the gold standard, is limited by time delays and reduced sensitivity. Biomarkers such as C-reactive protein (CRP) are increasingly being investigated for their diagnostic utility in suspected pediatricsepticemia. Aim: The aim of this study was to evaluate the diagnostic role of CRP in comparison with blood culture in children admitted with suspected septicemia. Methods: This retrospective observational study was conducted at the Department of Pediatrics, Government Medical College Srinagar, and included 190 children aged 1 month to 18 years admitted with suspected sepsis between July 2023 and July 2025. Demographic details, clinical presentation, and laboratory parameters including C-reactive protein (CRP) levels and blood culture results were retrieved from hospital records. CRP values were categorized as <10 mg/L, 10–30 mg/L, and >30 mg/L. Blood cultures were processed according to standard microbiological protocols. The diagnostic performance of CRP in predicting blood culture positivity was assessed in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: Out of 190 children, males constituted 55.8% and females 44.2%, with the majority belonging to the 1–5 year age group. Fever was the most common presenting symptom, followed by respiratory distress, seizures, and altered sensorium. Elevated CRP levels (>10 mg/L) were recorded in 73.2% of cases. Blood cultures were positive in 33.7% of patients, with Gram-negative organisms such as Klebsiella and Escherichia coli being predominant, although Staphylococcus aureus was also frequently isolated. A significant association was observed between higher CRP levels and culture positivity. CRP demonstrated a sensitivity of 87.5% and specificity of 42.9% in predicting culture-proven sepsis, with PPV of 40% and NPV of 88.9%. These findings highlight that while CRP is a sensitive screening tool for pediatric sepsis, its limited specificity necessitates confirmation with blood cultures. Conclusion: The study concludes that while CRP is a useful adjunctive marker with high sensitivity and negative predictive value, its limited specificity restricts its use as a standalone diagnostic test. However, when interpreted in combination with clinical features and blood culture results, CRP can serve as an important tool for early detection and management of pediatricsepticemia