Comparative efficacy of micro-erythrocyte sedimentation rate (m-ESR) and C-reactive protein (CRP) as a neonatal septic screening marker—a single-center, retrospective observational study

Abstract

Abstract Background Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in neonatal period. Most of neonatal sepsis-related morbidity and mortality can be prevented by early diagnosis and treatment with appropriate antimicrobial agents. Micro-erythrocyte sedimentation rate (m-ESR) is a simple, inexpensive, and rapid screening test for neonatal sepsis that can be done even in resource limited setups. Objectives To compare the efficacy of m-ESR with C-reactive protein (CRP) as a screening tool in neonatal sepsis. Methodology A retrospective chart-based analysis was done in division of neonatology, of our tertiary care hospital over a period of 21 months. A total of 202 suspected cases of neonatal sepsis with documented CRP and micro-ESR values were included. We evaluated the role of micro-ESR as a screening tool in neonatal sepsis in comparison with CRP. The validity and reliability of micro-ESR in comparison to CRP were estimated and its sensitivity, specificity, positive, and negative predictive value to diagnose sepsis were calculated. Results There was a significant correlation between micro-ESR and CRP with a moderate degree of agreement, especially in ‘late onset sepsis’ group. The overall sensitivity, specificity, positive predictive value and negative predictive value of micro-ESR were 67%, 84%, 58%, and 89% respectively. Conclusion Micro-ESR is a simple, inexpensive test comparable to CRP in screening for neonatal sepsis.

Keywords

• C-reactive protein
• Micro-ESR
• Neonatal sepsis
• Screening test