Published: 2020-03-21

A prospective study of inflammatory biomarkers in neonatal sepsis at a tertiary level hospital

Sandeep D. Paimode, Kuldeep Kumar Sharma, Navjot Kour


Background: Sepsis in neonates is a syndrome which is characterized clinically by systemic symptoms or signs of infection and associated with bacteremia in the first 28 days of life. More than 40% of under-five deaths globally occur in the neonatal period, resulting in 3.1 million newborn deaths each year. Procalcitonin (PCT) is an early diagnostic tool for neonatal sepsis.

Methods: Present prospective cross- sectional observational study was conducted at NICU of Base hospital, Delhi Cantonment from 1st Dec 2016 to Jan 31st, 2018. Universal sampling technique was followed. SPSS version 21 was used for statistical analysis. A p-value of less than 0.05 was taken as significant.

Results: Out of the total 440 cases, 63% were males while rest 37% were females.  Mean gestation age and birth weight of the babies was 35.6 weeks and 2.13 Kg respectively. Raised/ decreased Total Leucocyte Count (TLC) and raised pro calcitonin levels were seen in 23% and 19.8% cases respectively.

Conclusions: These results indicated that the sensitivity of procalcitonin was higher than TLC for the diagnosis of culture proven neonatal sepsis. Hence, PCT is a more sensitive and useful biomarker for the diagnosis of neonatal sepsis.


Biomarkers, Neonate, Procalcitonin, Sepsis, Total leucocyte count

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UNICEF, WHO, The World Bank, and The United Nations, Levels and Trends in Child Mortality, UNICEF, New York, NY, USA; 2011.

Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010 Jun 5;375(9730):1969-87.

Bang AT, Bang RA, Baitule SB, Reddy MH, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999 Dec 4;354(9194):1955-61.

Network NN. National Neonatal Perinatal Database–report for the year 2002–2003. NNF NNPD network. New Delhi. 2005.

Lawn JE, Cousens S, Zupan J, Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? Where? Why?. Lancet. 2005 Mar 5;365(9462):891-900.

Viswanathan R, Singh AK, Ghosh C, Dasgupta S, Mukherjee S, Basu S. Profile of neonatal septicaemia at a district-level sick newborn care unit. J Health, Popula Nutr. 2012 Mar;30(1):41.

Mussap M, Noto A, Cibecchini F, Fanos V. The importance of biomarkers in neonatology. In Sem Fetal Neonatal Med. 2013 Feb 1:18(1): 56-64.

Ognean ML, Boicean A, Șular FL, Cucerea M. Complete blood count and differential in diagnosis of early onset neonatal sepsis. Revista Romana de Medicina Laborator. 2017 Mar 1;25(1):101-8.

Jyothi P, Basavaraj MC, Basavaraj PV. Bacteriological profile of neonatal septicemia and antibiotic susceptibility pattern of the isolates. J Nat Sci, Biol Med. 2013 Jul;4(2):306.

Oommen SA, Saini S, Kunkulol RR. Bacteriological profile of neonatal septicemia: A retrospective analysis from a tertiary care hospital in Loni. Inter J Med Res Health Sci. 2015;4(3):652-8.

Vaidya U, Bhave S, Hegde V, Pandit AN. Neonatal septicemia: a reappraisal with special reference to the use of cefotaxime. Indian Pediatr. 1991 Nov 1;28(11):1265-70.

Sharma A, Krishna Kutty CV, Sabharwal U, Rathi SU, Mohan H. Diagnostic and prognostic role of CRP and m-ESR in neonatal septicemia. Indian Pediatr. 1993 Mar 1;30:347-9.

Anand NK, Gupta AK, Mohan M, Lamba IM, Gupta R, Srivastava L. Coagulase negative staphylococcal septicemia in newborns. Indian Pediatr. 1991 Nov;28(11):1241-8.

Galhotra S, Gupta V, Bains HS, Chhina D. Clinico-bacteriological profile of neonatal septicemia in a tertiary care hospital. J Mahatma Gandhi Institute Med Sci. 2015 Jul 1;20(2):148.

Chugh K, Aggarwal BB, Kaul VK, Arya SC. Bacteriological profile of neonatal septicemia. Ind J Pediatr. 1988 Nov 1;55(6):961-5.

Muley VA, Ghadage DP, Bhore AV. Bacteriological profile of neonatal septicemia in a tertiary care hospital from Western India. J Global Infectious Dis. 2015 Apr;7(2):75.

Basu R, Bandyopadhyay S. Study on correlation between sepsis screening and blood culture in neonatal sepsis. Morbidity Mortality. 2014 May;6:7.

Arif S, Ehsan A, Arif M, Hussain J, Bano R. Early diagnosis of neonatal sepsis through haematological and biochemical markers. Gomal J Med Sci. 2012;11:178-82.

Berger C, Uehlinger J, Ghelfi D, Blau N, Fanconi S. Comparison of C-reactive protein and white blood cell count with differential in neonates at risk for septicaemia. Europ J Pediatr. 1995 Feb 1;154(2):138-44.

Ahmed Z, Ghafoor T, Waqar T, Ali S, Aziz S, Mahmud S. Diagnostic value of Creactive protein and haematological parameters in neonatal sepsis. J Coll Physicians Surg Pak. 2005 Mar;15(3):152-6.

Maamouri G, Boskabadi H, Sayedi SJ, Bagheri F, Boskabadi A. The Evaluation of Serum Procalcitonin Levels in Neonatal Infections. Inter J Pediatr. 2017;5(7):5287-94.

Adib M, Bakhshiani Z, Navaei F, Fosoul FS, Fouladi S, Kazemzadeh H. Procalcitonin: a reliable marker for the diagnosis of neonatal sepsis. Iran J Basic Med Sci. 2012 Mar;15(2):777.