Value of Serial Measurement of C - reactive protein in Assessment of Clinically Suspected Neonatal Sepsis
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 12
Abstract
Abstract: A prospective cohort study was conducted at Neonatal care unit of Department of Paediatrics, Sahaeed Ziaur Rahman Medical College Hospital. From July 2012 to December 2012 to determine value of serial measurement of C - reactive protein in assessment of clinically suspect neonatal sepsis. Total 100 patients were assessed. Fifty new born were included as cases (Group-A) & fifty were included as control (Group-B). Among total 100 patients, 55 were male baby and 45 were female baby. In group-A, 28 neonate were male and 22 were female. In group-B, 27 were male and 23 were female. In this study, there is male preponderance among the suspected cases of neonatal sepsis. Male and female ratio is 14:11. Most of the parents were from Bogura (68%) and rest was from Gybandha, Sirajgonj and Naogaon. Economic status was mostly slightly sufficient (72%). About 33% parents were illiterate, 56% parents were literate, 09% parents were educated and 02% of the parents were highly educated. All neonates selected as control were delivered by doctors posted in Gynea and Obstetric department of this hospital. 32% of neonates in group-A were given intrapartum antibiotic prophylaxis whereas 58% of those in group-B were given so. In group-A, 68% were delivered by naturals, 26% by cesarean section and 6% were delivered by assistance. In group-B, 60% were delivered by naturals, 36% by cesarean section and 4% were delivered by assistance. 74% of cases in group-A, sterile or clean instruments were used to cut cord whereas that was done in 100% of the control. On admission or during enrollment in study 74% of the cases in group-A had positive CRP and 30% of the control in group-B had positive CRP. There was significant difference between two groups. All the demographic features, clinical records and laboratory data were compared between case (Group-A) and controls (Group-B). Distribution of the newborn pair in group-A and group-B was analyzed with chi square test. Among four serial measurement of CRP, first three serum samples show significant difference of positive CRP level between cases and controls. There is no significant difference of positive CRP level in last sample taken before discharge between cases and controls .It can be concluded that positive CRP level can be considered as a useful indicator alternative to blood culture to diagnose sepsis in neonate in our setup when it is correlated with clinical data and easily available laboratory findings i.e thrombocytopenia, total leucocyte count etc. Serial measurement of CRP can be considered as a valuable indicator to see the prognosis of neonatal sepsis.
Authors and Affiliations
Dr. Md. Homayun Shikdar, Dr. Anjana Basak, Dr. Sharmin Afrozy
Keywords
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