Comparative evaluation of blood culture, estimation of immunoglobulin m (igm) and c-reactive protein (crp) detection in the diagnosis of neonatal sepsis
Journal Title: INTERNATIONAL JOURNAL OF CURRENT RESEARCH - Year 2014, Vol 6, Issue 2
Abstract
This clinical study was conducted to evaluate the diagnostic value of C-reactive protein (CRP), Immunoglobulin M (IgM) in the early diagnosis of neonatal sepsis. The diagnostic values of each marker separately or in combination were evaluated. Blood culture, IgM and CRP estimation were performed on 50 clinically suspected to have septicemia. Blood culture positive were seen in 54.0% cases with predominant organism being Klebsiella pneumoniae (47.8%) and among Gram positive Staphylococcus aureus (13.1%). IgM level >20mg/dl (cut off value) was found in 46.0%cases and CRP level >5mg/dl (cut off value) was seen in 52.0% of culture proven sepsis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CRP versus blood culture were 91.30, 81.40, 80.77 and 91.67 respectively, IgM versus blood culture were 86.90, 88.89, 86.96 and 88.89 respectively and combined IgM & CRP versus blood culture were 95.65, 81.48, 81.41 and 96.65 respectively. CRP is a single useful marker with high sensitivity and IgM with high specificity in predicting neonatal sepsis. Combination of these tests showed higher sensitivity and negative predictive value when compared to CRP and IgM estimation alone in diagnosing septicemia. CRP and IgM in combination sensitivity increased from 91.30%-95.65% and can be used as better predictor of neonatal infection and helpful in predicting neonatal sepsis while awaiting for culture report. We speculate a significant role of this combination in making decisions regarding antibiotics treatment and upgrading the level of medical care.
Authors and Affiliations
Kamble Arati Nagarathnamma T. ,, Asha Benakappa
Keywords
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