Online ISSN: 2515-8260

Keywords : Blood culture

Prognostic significance ofProcalcitonin, High sensitivity C-reactive proteinandwhite blood cell count incomparison withblood culture in ICU patients with Sepsis and Septic shock inatertiary care Hospital

Dr.Kondle Raghu; Dr. Krishnan Ramalingam

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2263-2270

Background: Sepsis is a life-threatening condition in ICU with high morbidity and
mortality. Biomarkers which can act as a predictor for diagnosis, prognosis, and patient
outcome in sepsis are needed.
Aim:Aim of the study is to compare the significance of hs-C-reactive Protein (CRP),
Procalcitonin, White blood cell count, and blood culture in patients with bloodstream
infections and compare their prognostic significance with blood cultures in sepsis.
Materials and Methods: This hospital based prospective observational study was conducted
between July 2018 to July 2019 forone year with 216 cases of sepsis. Serial determination
of Procalcitonin and CRP at admission and Day 6 was done. Data was analyzed check to
compare the prognostic significance of the PCT, CRP, and WBC count.
Results:A blood culture positivity rate of 50.9% was reported with male preponderance.
WBC count has significantly reduced after 72hrs of admission (p= 0.007). CRP levels have
significantly reduced on day 6 (p = 0.043) in comparison to at the time of admission (p=
0.032). The serial determination of PCT levels at admission and on day 6 (p= 0.032) was
found to be a better prognostic indicator in patients with sepsis than at the time of
admission. The significant patient outcome in terms of mortality and reduction in length of
hospital stay has been found (p= 0.018, p=0.002). The positive correlation of PCT and CRP
and SOFA score has been reported.
Conclusion: Prognostic significance was found for the biomarkers PCT, CRP, and WBC
count with significant patient outcomes in terms of mortality and hospital stay reduction

Aetiological profile, risk factors, antibiotic sensitivity pattern and outcome of neonatal sepsis in tertiary care hospitals- a prospective observational study


European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1073-1087

Introduction:Neonatal sepsis is an important cause of morbidity and mortality in developing countries.According to the World Health Organization(WHO),around5 million newbornsdie yearly, 98% of deaths occurring in developing countries
Objectives: To identify prevalence of neonatal sepsis,aetiological profile,antibiotic sensitivity pattern and outcome in a tertiary care centre and to formulate a consensus recommendation for empirical antibiotic usage for neonatal sepsis in our hospital.
Method:A hospital based prospective observational study was done from March 2019 to August 2020 on babies diagnosed or suspected as cases of neonatal sepsis in our hospital.
Results:Atotal of 200 neonates were included in our study with clinical suspicion of sepsis during the study period. 127 (63.5%) neonates were identified as EOS (0-3 days) and 73 (36.5%) aslate onset sepsis (4-28 days).Prematurity was thecommonest predisposing factor(68.5%).Feeding intolerance was the commonest presentation (74%).Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of C-reactive protein (CRP) + absolute neutrophil count (ANC) were 93.8% ,90.8%, 34.9%, 99.6% and 90.9% respectively.(p <0.001).Klebsiella pneumonia + Klebsiellaoxytoca(16+1) was the most common isolate (35.4%),There were 6 (12.5%) isolates of Staphylococcus aureus out of which 2 were methicilin resistant aureus(MRSA).
Conclusions:Of the 200 neonates with suspected neonal sepsis,63.5% had EOS. Prematurity was the commonest predisposing factor(68.5%) and feeding intolerance was the commonest presentation (74%).Klebsiella (35.4%) was the most common isolate.