Diagnostic Utility of C-Reactive Protein and Permutation Combination of Quantitative and Qualitative Haematological Parameters in Neonatal SepsisCorrespondence Address :
Dr. Mohasin Jakirhusain Halgale,
816/3, Plot No. 6, Karande Mala, Devane Colony, Opp. Sriram Residency, Kolhapur-416003, Maharashtra, India.
Introduction: Neonatal sepsis at times is subclinical and lacks specific symptoms. C-Reactive Protein (CRP) which is an acute phase reactant protein is thought to be an alternative biomarker to blood culture. Haematological parameters of sepsis are indirect biomarkers of infection. Authors found it worthwhile to discern efficacy of haematological parameters obtained by such three part haematology analysers in diagnosis of neonatal sepsis, when used in their pure form or with peripheral blood smear or with CRP, in isolation or in their combinations.
Aim: To find out the diagnostic utility of combinations of haematological parameters as obtained by three part differential automated haematology analyser and peripheral blood smear along with CRP in neonatal sepsis.
Materials and Methods: This observational and analytical study of diagnostic test outcome was carried out over a period of 12 months from January - December 2016 in Rajarshi Chhatrapati Shahu Maharaj Medical College & Chhatrapati Pramilaraje Rugnalaya, Kolhapur, Maharashtra, India, with special reference to clinical profile, blood culture, qualitative and quantitative haematological parameters and CRP. The statistical analysis included calculating diagnostic utility of isolated and combination of parameters and performing Chi-square test to study difference in frequency of occurrence and significance of association.
Results: The culture proven sepsis was seen in 73 (70.2%) cases while probable sepsis was seen in 31 (29.8%) cases. There were 32 (30.8%) fatalities. With parallel method with OR values, combination of Haemoglobin, Platelet parameters and White Blood Cells (WBC) parameters as obtained by analyser and peripheral blood smear exhibited sensitivity of 98.6%, specificity and Positive Predictive Value (PPV) of 100%, Negative Predictive Value (NPV) of 96.9% and Diagnostic Accuracy (DA) of 99%. This was surpassed by combination of CRP and all these parameters to attend values of 100%. Combination of all haematological parameters obtained purely by analyser showed these values to be 89%, 100%, 79.5% and 92.3%. Immature to Total WBC (I:T) ratio and platelet count influenced clinical outcome of fatality.
Conclusion: The liberal use of combination of haematological parameters is rewarding in supporting diagnosis of neonatal sepsis. The same was obtained by purely using analyser which showed remarkable diagnostic utility suitable for resource poor settings.
Biomarkers, Infection, Screening score, 3 Part differential haematology analyser
Date of Submission: May 16, 2021
Date of Peer Review: Aug 15, 2021
Date of Acceptance: Sep 29, 2021
Date of Publishing: Oct 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: May 17, 2021
• Manual Googling: Sep 28, 2021
• iThenticate Software: Sep 30, 2021 (6%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)