Reliability of C-Reactive Protein in the Diagnosis of Neonatal Sepsis in Combined Military Hospital, Malir

Ayesha Asif; Ameena Saba; Syed Taqi Hassan Zaidi; Wasif Shujaat Ali; Muhammad Hanif; Mobassir Ali Akbar

doi:10.71104/jsogp.v16i1.1014

Ayesha Asif FCPS Pediatric Resident - Combined Military Hospital, Malir Cantt Karachi
Ameena Saba Associate Professor, Paeds, CMH/ Karachi institute of medical sciences Malir Cantt Karachi
Syed Taqi Hassan Zaidi Associate Professor, Paeds, CMH/ Karachi institute of medical sciences Malir Cantt Karachi
Wasif Shujaat Ali Assistant Professor, Paeds, CMH/ Karachi institute of medical sciences Malir Cantt Karachi
Muhammad Hanif Assistant Professor, Paeds, SRMC
Mobassir Ali Akbar Family medicine resident, Ziauddin University Karachi

DOI: https://doi.org/10.71104/jsogp.v16i1.1014

Keywords: Neonatal sepsis, CRP

Abstract

Objective: To determine the reliability of C-reactive protein (CRP) as an early diagnostic biomarker for neonatal sepsis by assessing its correlation with clinical features, and potential perinatal risk factors, in order to support its use as a rapid and accessible tool for early diagnosis and management.

Methodology: A descriptive cross-sectional study was conducted at the Neonatology Unit of Combined Military Hospital (CMH), Malir, over a period of six months, from July 2021 to November 2021. All neonates aged ≤28 days, of either gender, presenting with signs and symptoms suggestive of sepsis such as lethargy, poor feeding, temperature instability, respiratory distress, or convulsions were included. A total of 2 to 3 mL of venous blood was drawn aseptically from each neonate for CRP testing. A CRP level greater than 10 mg/L was considered positive and indicative of infection, serving as a key marker in assessing the likelihood of neonatal sepsis. All data were entered and analyzed using SPSS version 25.

Results: A total of 101 neonates were assessed, with 51.5% being male and 48.5% female. Among them, 96% had a positive CRP level. The most common clinical features observed were lethargy (72.3%), reluctance to feed (51.5%), and persistent vomiting (46.5%). CRP levels were predominantly in the range of 6–30 mg/L (51.5%) and 31–50 mg/L (40.6%). There was a statistically significant association between CRP status and both mode of delivery (p = 0.020) and type of feeding (p = 0.042), while no significant association was found with age, gender, PROM, meconium-stained liquor, or maternal fever (p=>0.05).

Conclusion: C-reactive protein observed to be a reliable and accessible biomarker for the early diagnosis of neonatal sepsis, with its positivity rate of 96% among clinically suspected cases and strong alignment with key clinical features such as lethargy and feeding difficulties, CRP proves to be a valuable diagnostic aid in neonatal care.