Clinical Utility of Procalcitonin and C-Reactive Protein in the Management of Neonatal Sepsis in a Resource-Limited Nigerian Hospital.

Journal: Nigerian journal of clinical practice

Volume: 26

Issue: 12

Year of Publication: 2024

Affiliated Institutions:  Department of Chemical Pathology, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. Department of Paediatrics, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. Department of Medical Microbiology, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. Department of Chemical Pathology, Federal Teaching Hospital, Ido Ekiti, Ekiti, Nigeria. Department of Medical Microbiology, Federal Teaching Hospital, Ido Ekiti, Ekiti, Nigeria. Child and Adolescent Mental Health Service, Lincolnshire Partnership NHS Foundation Trust St. George's, Lincoln, Lincolnshire LN FS, United Kingdom.

Abstract summary 

Neonatal sepsis is an invasive infection of the bloodstream in neonates and a leading cause of morbidity and mortality among them.To investigate the role of procalcitonin (PCT) and C-reactive protein (CRP) in the management of neonatal sepsis.This was a prospective case-control study over one-year period using convenience sampling. Blood samples for PCT and CRP were taken from all neonates, while blood culture and white blood cell count samples were additionally taken from babies with neonatal sepsis. PCT and CRP were repeated at 24 and 48 hours. The continuous variables were found to have a nonparametric distribution. They were presented as median and interquartile range, and compared using Wilcoxon signed rank and Friedman test as appropriate.The blood culture analysis yielded a prevalence of 12.7% with Staphylococcus aureus being the commonest organism. Baseline concentrations of PCT (1.28 ng/ml) and CRP (17.31 mg/L) in neonates with sepsis were higher than that of controls (PCT-0.63 ng/ml, CRP-5.40 mg/L). PCT concentrations decreased after two days of antibiotic treatment, while CRP concentrations decreased after a day. The concentration of both decreased to normal levels after two days of treatment.This study showed that CRP was more reliable in monitoring antibiotic therapy, unlike other studies which suggested PCT. In cases where the management of neonatal sepsis may be limited by a low blood culture yield, therapeutic monitoring may be aided by CRP and/or PCT.

Authors & Co-authors:  Jimoh A K AK Bolaji O B OB Adelekan A A Ghazali S M SM Oyekale O T OT Adeleke B A BA Ojo B O BO Popoola G O GO Lawal O A OA Ajetunmobi W A WA

Study Outcome 

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Statistics
Citations :  Seale AC, Blencowe H, Manu AA, Nair H, Bahl R, Qazi SA, et al. Estimates of possible severe bacterial infection in neonates in sub-Saharan Africa, south Asia, and Latin America for 2012: A systematic review and meta-analysis. Lancet Infect Dis 2014;14:731–41.
Authors :  10
Identifiers
Doi : 10.4103/njcp.njcp_397_23
SSN : 1119-3077
Study Population
Male,Female
Mesh Terms
Infant, Newborn
Other Terms
Study Design
Study Approach
Country of Study
Nigeria
Publication Country
India