Objective: Sepsis often prompts clinicians to start empirical antibiotics in suspected neonates while awaiting diagnosis. The next-generation testing with point-of-care techniques offers a lead time advantage that could bridge the gap by providing a timely diagnosis.
Materials and methods: We conducted a prospective diagnostic study in 82 neonates enrolled between May and October 2022 in a level III neonatal intensive care unit. All neonates with a new episode of clinically suspected sepsis were included. Diagnostic accuracy of point-of-care (POC) testing of C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin with standard laboratory methods was performed.
Results: The mean gestation age and birth weight of the neonates were 33.17 ± 4.25 weeks and 1695.4 ± 700.74 grams respectively. Most neonates were preterm (75%) with nearly equal proportions of early (51.22%) and late-onset (48.78%) sepsis. The point-of-care CRP correlated well with standard CRP (r = 0.8001, 95% CI: 0.706 - 0.867, p < 0.0001). Amongst the three biomarkers, CRP had the maximum diagnostic accuracy (AUC - 0.73) followed by procalcitonin (AUC - 0.65) and IL-6 (0.55). There was no significant difference in the diagnostic accuracy of CRP (p = 0.46), procalcitonin (p = 0.29), and IL-6 (p = 0.60) in early and late-onset sepsis. The mean time for point-of-care estimation of IL-6, PCT, and CRP was 12 ± 3 minutes which was significantly less compared to 366 ± 61 minutes for standard techniques. (p < 0.001).
Conclusion: Point-of-care CRP correlates well with standard techniques of estimation, and CRP alone and in combination with procalcitonin has good diagnostic accuracy in neonatal sepsis.
The Author(s). Published by S. Karger AG, Basel.