NEONATAL SEPSIS: ROLE OF RAPID DIAGNOSTIC BIOMARKERS IN EARLY DETECTION
Main Article Content
Keywords
Neonatal sepsis, C-reactive protein, Procalcitonin, Molecular assays, Biomarkers, Early detection.
Abstract
Background: Neonatal sepsis is a leading cause of morbidity and mortality worldwide. Early recognition is difficult due to nonspecific clinical signs and the limitations of blood culture, which remains the diagnostic gold standard but is slow and often insensitive.
Objective: To evaluate the diagnostic role of rapid biomarkers—C-reactive protein (CRP), procalcitonin (PCT), and molecular assays—in the early detection of neonatal sepsis.
Methods: Neonates with suspected sepsis were studied. CRP and PCT levels were measured at admission and repeated at 24–48 hours. Molecular assays (PCR/multiplex) were performed on blood samples. Blood culture served as the reference standard. Diagnostic accuracy was assessed using sensitivity, specificity, predictive values, and ROC analysis.
Results: CRP was useful for monitoring trends but showed delayed rise. PCT provided earlier specificity for bacterial infection, though interpretation was limited in the first 48 hours of life. Molecular assays enabled rapid pathogen identification and resistance profiling with high sensitivity. Combined biomarker strategies improved diagnostic accuracy compared to single markers.
Conclusion: CRP, PCT, and molecular assays complement traditional diagnostics. Their integration into clinical workflows enhances early recognition, supports rational antibiotic use, and improves neonatal outcomes.
References
2 Wynn JL. Defining neonatal sepsis. Curr Opin Pediatr. 2016;28(2):135–140.
3 Ng PC, Lam HS. Diagnostic markers for neonatal sepsis. Biomark Med. 2014;8(9):1053– 1069.
4 Resch B, Gusenleitner W, Müller W. Procalcitonin in neonatal sepsis diagnosis. Acta Paediatr. 2015;104(1):e1–e9.
5 Vouloumanou EK, Plessa E, Karageorgopoulos DE, Mantadakis E, Falagas ME. CRP and PCT in neonatal sepsis: meta analysis. Pediatr Infect Dis J. 2011;30(8):693–700.
6 Sharma D, Farahbakhsh N, Shastri S, Sharma P. Biomarkers for neonatal sepsis: a review. J Matern Fetal Neonatal Med. 2018;31(12):1646–1658.
7 Stocker M, van Herk W, El Helou S, Dutta S, Schuetz P, et al. Procalcitonin guided decision making in neonatal sepsis. Lancet Infect Dis. 2017;17(7):728–739.
8 Pammi M, Flores A, Leeflang MMG, Versalovic J. Molecular assays for neonatal sepsis: systematic review. Pediatrics. 2017;139(3):e20162890.
9 Wynn JL, Wong HR. Biomarkers in neonatal sepsis: state of the art. Clin Perinatol. 2022;49(1):221–240.
10 Rees CA, Lim J, Westbrook AL, El Helou R, Leeflang MMG, Pammi M, et al. Systematic review and meta analysis of biomarkers in neonatal sepsis in LMICs. BMJ Paediatrics Open. 2023;7(1):e001627.
11 Beaumont R, Tang K, Gwee A. Sensitivity and specificity of procalcitonin in neonatal sepsis. Hosp Pediatr. 2024;14(3):199–208.
12 Lee CY, Zven SE, Sathya SA, Abukhalaf D, Sahoo S, Samal P, Prescott SM. Molecular methods in neonatal sepsis: scoping review. Front Pediatr. 2025;13:1625449.
13 Dierikx TH, Visser DH, de Meij T, Versalovic J, Leeflang MMG, Cooper C, Pammi M. Molecular assays for neonatal sepsis: diagnostic accuracy review. Cochrane Database Syst Rev. 2025;3:CD011926.
14 Sonoli S, Dipty D. Procalcitonin and hs CRP in neonatal sepsis: diagnostic accuracy. J Chem Health Risks. 2025;15(3):8160.
15 Mahjoub W, Mohamed AE, Hamad K, Elkhatim SE. Procalcitonin, CRP and CBC as diagnostic markers for neonatal sepsis. IOSR J Dent Med Sci. 2025;24(10):34–41.
16 Yadav SN, Adhikari S, Mandal A, Jha R, Parajuli B, Rawat A, Yadav PC. Role of procalcitonin in the diagnosis of neonatal sepsis: prospective study. TWASP Press. 2025.
17 Dhamsaniya D, Parmar A, Kharadi H, Bhadresh M, Vyas B. Importance of CRP as an early indicator for neonatal sepsis. Int J Contemp Pediatr. 2025;12(3):6476.
18 Wang X, et al. CRP shows stronger accuracy for early onset sepsis in preterm newborns: cohort analysis. News Medical. 2025.
19 Adhisivam B. Point of care diagnostic markers for neonatal sepsis. Indian J Pediatr. 2024;91(5):537–538.
20 Chris A, Lim J, Westbrook AL, El Helou R, Leeflang MMG, Pammi M. Biomarkers for neonatal sepsis. Clin Perinatol. 2021;48(2):221–240.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. P. Periyasamy
Assistant Professor, Department of Pediatrics, Madurai Medical College, Tamil Nadu, India.
Dr. M. Paramaguru
Assistant Professor, Department of Pediatrics, Madurai Medical College and Government Rajaji Hospital, Tamil Nadu, India.
Dr. M. Edwin Raja
Assistant Professor, Department of Pediatrics, Madurai Medical College, Tamil Nadu,
