Abstract Ref Number = APCP1028
Diagnostic Value of Combination Between Leukocyte Count, Micro-Erythrocyte Sedimentation Rate and C-Reactive Protein in Neonatal Sepsis
Ading Rohadi,Renya Hiasinta,Atika Akbari,Afifa Ramadanti,Indrayadi
Department of Child Health Faculty of Medicine of Sriwijaya University Moh Hoesin Hospital Palembang Department of Child Health, Faculty of Medicine Sriwijaya University Mohammad Hoesin Hospital Palembang
Background : Early diagnosis of neonatal sepsis is difficult due to its nonspecific presentation. Blood culture is the gold standard for diagnosis, but it is time consuming and demands a well-equipped laboratory. Leukocyte count, micro-erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) are rapid examinations that may be of value individually or in combination in detecting neonatal sepsis. The aim of this study is to assess the value of combination between three parameters of peripheral blood leukocyte count, micro-ESR and CRP in prediction of neonatal sepsis.
Material : A diagnostic study on clinical sepsis neonates was conducted from July until September 2016 in the Neonatology Ward of Mohammad Hoesin Hospital. Subjects underwent examination of leukocyte, micro-ESR, CRP and blood culture simultaneously. Diagnostic value of leukocyte, micro-ESR, CRP and their combination were analyzed by comparison with blood culture.
Results : Twenty-six of 94 neonates had positive bacterial culture. Leukocyte measurement had sensitivity of 50%, specificity of 50%, positive predictive value (PPV) of 27.7%, negative predictive value (NPV) 72.3%, and accuracy 50%. Micro-ESR measurement had sensitivity of 61.5%, specificity of 61.8%, PPV of 38.1%, NPV of 80.8%, and accuracy of 61.7%. C-reactive protein measurement had sensitivity of 73.1%, specificity of 69.1%, PPV of 47.5%, NPV of 87%, and accuracy of 70.2%. The combination of three parameters measurement had sensitivity of 23.1%, specificity of 92.6%, PPV of 54.5%, NPV of 75.9%, and accuracy of 74.5%. The combination of two or more parameters had sensitivity 69.2%, specificity 64.7%, PPV 42.9%, NPV 84.6%, and accuracy 65.9%.
Conclusions : The combination of three parameters has highest specificity, PPV and accuracy, whereas the single CRP parameter has highest sensitivity and NPV.
Keywords: neonatal sepsis CRP Leukocyte microESR