Abstract:
Background: Neonatal sepsis (NS) is a signifcant health concern causing high morbidity and
mortality among neonates. The clinical symptoms of NS can overlap with other common
neonatal conditions. The gold standard diagnostic method, the blood culture test, has numerous limitations including lengthy turnaround time, which delays appropriate management of
NS. Acute phase protein; procalcitonin (PCT) and C-reactive protein (CRP) tests have emerged
as potential alternatives due to short turnaround times, high sensitivity, and specifcity in
detecting NS. Nevertheless, there is limited data on their usability in Kenyan public hospitals.
This study, therefore, was conducted to validate the performance of PCT and CRP tests in
diagnosis of NS locally.
Methodology: Blood samples were collected from 196 neonates with suspected sepsis
admitted at Moi Teaching and Referral Hospital (MTRH). Blood culture was performed using
BacT/ALERT blood culture system. Bacteria growths were identifed and antibiotic susceptibility
for the isolates determined using Vitek II. Serum PCT levels were determined using the
chemiluminescence immunoassay method. Serum CRP levels were measured using Immunoturbidimetry method.
Results: Growth of organisms occurred in 45.4% of the sepsis suspected neonates. The
sensitivity, specifcity, positive predictive value, negative predictive value and area under the
curve for PCT were 93.3%, 98.1%, 97.6%, 94.6% and 0.959, whereas for CRP they were 100%,
72.8%, 74.3%, 100%, and 0.953, respectively.
Conclusion and Recommendation: The CRP test exhibited superior sensitivity, negative predictive value, but lower specifcity, making it a more valuable tool for ruling out NS. Overall,
however, PCT emerged as a more robust biomarker, offering a reliable balance between sensitivity and specifcity, indicating its ability to identify cases with NS correctly. The area under the
ROC curve confrms that CRP and PCT have high accuracy in detecting NS. The study recommends adoption of PCT and CRP biomarkers in the diagnostic protocols for NS
