The importance of levels of serum CRP PCT and CD64 in early diagnosis of neonatal sepsis

Sepsis is a reason of morbidity and mortality for newborn babies. Therefore diagnosis and treatment is urgent. Diagnosis of septicemia is classically made by the demonstration of bacteria in the blood, usually by blood culture. It is difficult to diagnose sepsis because sepsis often has no specific symptoms. The lack of specific symptoms and signs of sepsis, results of the blood cultures take a time and sometimes results can be false negative. Researchers are working towards developing fast and accurate laboratory diagnostic tests. In this study we targeted to compare the diagnostic efficacies between serum C–reactive protein (CRP), procalcitonin (PCT), flow cytometric measurement of neutrophil (Cluster of differentiation 64 (CD64 (g, m), Cluster of differentiation 11B (CD11B (g,m)) and the complete blood count (immature mature neutrophil ratio (I/T), absolute band count (ABC), white blood cell count and platelet count in neonatal sepsis. This study was made between 2013 May and 2014 January in Department of Pediatrics, University of Fırat University Neonatal Intensive Care Unit. The patient group was composed of septic newborns (n=40), clinical septic newborns (n=48) and the control group (n=40). Samples were taken at the time of diagnosis of sepsis before antibiotic treatment. The parameters were compared before starting antibiotic treatment and 24 hours after starting antibiotic treatment The following optimal cutoffs for the diagnosis of sepsis were found: CRP: 3, 19 mg/dL (sen.: 70%, spec.: 90%), 0.17 ng/ml (sen.: 88%, spec.: 87, 5%), CD64g :64, 9 (sen.: 60%, spec.: 90%), CD64m:71, 6 (%) (sen.: 75%, spec.: 57%), CD11Bg: 99.3 (sen.: 69%, spec.: 60%), CD11Bm: 94.2 (sen.: 44%, spec.: 77%), CD64g–CB11Bg :63, 7 (sen.: 60%, spec.: 90%), CD64m–CD11Bm :72, 7 (sen.: 50%, spec.: 90%), I/T: 0, 18 (sen.: 97, 5%, spec.: 90%), ABC: 686 (sen.: 97%, spec.: 97%). The sensitivity of I/T, ABC, procalcitonin and the specificity of CRP, PCT, CD64g, CD64g–CD11Bg, CD64m–CD11Bm, I/T, ABC was significantly higher in early diagnosis of neonatal sepsis. CD64 g, CD64g–CD11bg, CD64m–CD11Bm could be a medium reliable tool for early prediction of early–onset sepsis (less than CRP, procalcitonin, I/T and ABC). We found CD11Bg and CD11Bm had lower reliability. Keywords: Neonatal sepsis, C–reactive protein, Procalcitonin, CD64, CD11B..