IS PROCALCITONIN A BETTER DIAGNOSTIC MARKER THAN CRP IN NEONATAL SEPSIS?

OBJECTIVES: To study the diagnostic value of Procalcitonin (PCT) as compared to Creactive protein (CRP) in the diagnosis of neonatal sepsis. METHODS: This cross sectional study was conducted on 58 neonates in study and 16 in control group admitted in NICU, SN Medical College, Agra. Study group were divided into 2 groups viz. culture positive sepsis and culture negative sepsis. Blood culture, C - reactive protein, Procalcitonin and other investigations for sepsis were performed in all the subjects. RESULTS: PCT levels was raised in significantly higher number of 87.9% of study cases (87.9%) as compared to CRP which was positive in 55.2% (p= 0.0002). The sensitivity, specificity and positive predictive value (PPV) of PCT in detecting sepsis was 100 %, 90.09%, 100 % respectively as compared to CRP having sensitivity, specificity, PPV as 81.3%, 59.1% and 81.3% respectively. PCT was a significantly better diagnostic marker in preterm (p= 0.001), low birth weight newborns (p= 0.0002) and in early onset sepsis (p= 0.0007) in comparison to CRP. CONCLUSION: Serum level of PCT is a more reliable marker than CRP in the diagnosis of neonatal sepsis especially in preterm (< 37 wk. gestation), low birth weight (< 2.5 kg) newborns and early onset sepsis (< 72 hrs. of life).