Journal of


Journal of Islamabad Medical & Dental College (JIMDC); 2016:5(3):131-133 

 131 

 Original Article 
 

Diagnostic Value of Combined: C- Reactive Protein, 
Total Leukocyte Count and Platelet Count in Neonatal 

Sepsis 

 

Abstract 
 
Objective: This study was designed to evaluate the diagnostic 

value of combination of Total Leukocyte Count, Platelet count and 

C - reactive protein for the diagnosis of neonatal sepsis. 

Patients and Methods This cross-sectional study was conducted 

at Department of Pediatrics, DHQ hospital, Sargodha. Blood 

samples for Sepsis work-up including C-reactive protein (CRP), 

Platelet count, TLC and blood culture collected were before the 

initiation of antibiotic therapy. The complete blood count was 

done on the automated hematology analyzer; CRP level estimation 

was done by Latex agglutination method. Patient having abnormal 

values of TLC, CRP and Platelet count were followed by report of 

blood culture which was used as gold standard for the diagnosis of 

Neonatal sepsis. 

Results: There were 98(38%) male and 162(62%) female patients 

with mean age of 1.8 ± 1.6 days. C-reactive protein, total 

leukocytes counts and platelet count collectively, were abnormal in 

132(50.7%) suspected neonates with sepsis.  Blood culture was 

found positive in 166(63.8%) neonates. The sensitivity, specificity, 

positive and negative predictive value of combined abnormal CRP, 

total leukocyte counts and platelet count was 75.3%, 92.5%, 

94.6% and 67.9% respectively. 

Conclusion: The diagnostic value of combined abnormal tests 

(CRP, TLC and platelet count) was found significant and can be 

used for the early diagnosis of neonatal sepsis when boold culture 

results are awaited. 

Keywords: C - reactive protein, Neonatal sepsis, Total Leukocyte 

Count, Platelet count. 

Introduction 

Neonatal sepsis is defined as a clinical syndrome of 

bacteremia characterized by signs and symptoms of 

infection in the first four weeks of life.
1
 It encompasses 

various systemic infections of the newborn such as 

septicemia, meningitis, pneumonia and urinary tract 

infections. Neonatal sepsis is one of the major causes of 

neonatal mortality in the developing countries contributing 

to 12% of all neonatal deaths,
2
 and it continues to be a major 

cause of morbidity and mortality in Pakistan.
3
 Blood culture 

is still considered to be the ‘gold standard’ for diagnosis of 

neonatal sepsis. The yield of a positive blood culture ranges 

from 8-73% as shown in various studies.
4
-

7
 However, the 

technique of blood culture is time consuming and demands a 

well-equipped laboratory which is not available in most of 

the community hospitals.
5
 

Therefore, there is need for a test that is cheap and can be 

easily performed with quick availability of reports.
6
 An ideal 

diagnostic test for neonatal sepsis should have maximum 

sensitivity and specificity.
7
 There are other tests which may 

support diagnosis in such cases. CBC with the absolute 

neutrophil count and CRP are amongst the most frequently 

used.
8
 

Combination of abnormal total leukocyte count, platelet 

count and C - reactive protein have been used to evaluate 

infants with sepsis or with probable sepsis in different 

studies.
9
 In one study, the positive predictive value for 

combination (TLC, Platelet count, CRP) was 79.24%.
10

 The 

rationale of this study was to evaluate the diagnostic value 

for combination (TLC, platelet count and CRP) for 

evaluation of patients with neonatal sepsis. 

Patients And Methods 

This Cross-sectional study was carried out at Department of 

Pediatrics, DHQ hospital, Sargodha from March to August 

2014. Non-probability sampling technique was used and 

neonates suspected to have early neonatal sepsis were 

included. Neonatal sepsis was clinically suspected if a 

neonate presented within first 7 days after birth with two or 

more of these; temperature instability < 35 or > 38.5C, 

tachypnea > 60/min, tachycardia > 200/min or capillary 

refill > 3 sec.
11 

Neonate who received antibiotics before 

admission or having major congenital abnormalities were 

excluded. Approval was taken from hospital ethical 

committee and informed consent was obtained from parents. 

Each neonate was examined by a pediatric resident and 

blood samples were collected before the initiation of 

Corresponding Author: 

Dr Mohsin Butt  

E Mail: proudpakistani65@hotmail.com 

Received:  Aug 22, 2016; Accepted: Oct 16, 2016 

 

 

 

mailto:proudpakistani65@hotmail.com