The Role and Significance   of C – Reactive Protein in Neonatal Sepsis: A Clinical Investigation

*Jayanta Debnath1, Tapan Debnath2, Biswajit Majumdar3, Jayanta Poddar4

*Jayanta Debnath1, Tapan Debnath2, Biswajit Majumdar3, Jayanta Poddar4 1Assistant Professor, Department of Microbiology, Tripura Medical College and Dr. B.R. Ambedkar Hospital, Hapania, Agartala, Tripura, 799014. 2 Assistant Professor, Department of Biochemistry, Tripura Medical College and Dr. B.R. Ambedkar Hospital, Hapania, Agartala, Tripura, 799014. 3Professors, Department of Biochemistry, Gandaki Medical College, Tribhuvan University, Nepal. 4 Associate Professor, Department of Pediatrics, Tripura Medical College and Dr. B.R. Ambedkar Hospital, Hapania, Agartala, Tripura, 799014.

Abstract

OBJECTIVE: To evaluate the role of CRP in the management of neonatal sepsis in a NICU setting where resources for diagnosis and monitoring prognosis is minimal.

METHODOLOGY: The study was conducted at Dr. B.R. Ambedkar hospital, Agartala for a period of one year from March 2010 to February 2011. The data included neonates born with definite risk factor who were clinically evaluated and subsequently transferred to NICU. The admitted neonates were evaluated for laboratory values, out of which serial C – reactive protein estimation (CRP) was particularly studied and correlated with initiation and duration of antibiotic therapy.

RESULTS: Of 1533 clinically evaluated neonates, 352 were transferred to NICU. In 120 neonates, antibiotics were either discontinued before 48 hours or not treated based on serial CRP concentration. The majority of neonates (206) were treated for 3 to 5 days and 26 treated for six days or more. Peak CRP concentration primarily determined the duration of antibiotic therapy, with the mean CRP level rising from 2.4 mg/dl to 10.8 mg/dl from third to above sixth day of treatment. The mean duration of treatment was 3.4 days. No infant discharged with normal CRP value was readmitted in this hospital with signs of sepsis within one month.

CONCLUSION: Serial CRP estimation has been evaluated out to be a low cost, effective and rapid prognostic marker in acute infection. It definitely helps in deciding the initiation and duration of antibiotic therapy, thereby reducing unwanted antibiotic exposure and duration of hospital stay of neonates.

KEYWORDS: C – reactive protein; neonate; antibiotic; sepsis