COMPARATIVE PERFORMANCE OF PROCALCITONIN AND C-REACTIVE PROTEIN IN IDENTIFYING BACTERIAL INFECTION AMONG NEONATES WITH RESPIRATORY DISTRESS

Background: Bacterial infection in neonates presenting with respiratory distress can be difficult to distinguish from noninfectiouscauses because clinical manifestations are often nonspecific. Procalcitonin (PCT) and C-reactive protein (CRP)are commonly used inflammatory biomarkers, but their relative diagnostic performance may vary across neonatalpopulations. The aim/objective is to compare the diagnostic performance of serum PCT and CRP for identifying bacterialinfection in neonates with respiratory distress and to assess their association with blood culture findings and other indicatorsof infection. Materials and Methods: This hospital-based observational diagnostic study included 60 neonates, comprising30 infectious and 30 non-infectious cases. Serum PCT and CRP levels were compared between groups. Sensitivity,specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, and ROC-AUC wereassessed. The association between PCT, CRP, and blood culture results was also evaluated. Results: Mean PCT wassignificantly higher in the infectious group than in the non-infectious group (61.05 ± 50.764 vs. 23.01 ± 42.214 ng/mL; p<0.001). Mean CRP was also significantly higher (26.39 ± 36.836 vs. 4.97 ± 6.148 mg/dL; p = 0.005). CRP demonstrated83.3% sensitivity, specificity, PPV, NPV, and diagnostic accuracy, compared with PCT accuracy of 76.7%. AUC was 0.777for PCT and 0.822 for CRP (both p <0.0001). PCT and CRP showed a significant association (p <0.001). Conclusion: BothPCT and CRP showed useful diagnostic performance, with CRP demonstrating slightly superior overall accuracy. Theircombined assessment may provide complementary information for early identification of bacterial infection in neonates withrespiratory distress.