Comparison of Quantitative C-Reactive Protein with Blood Lactate Levels as Septic Markers in Neonatal Sepsis: A Cross-Sectional Study in a Tertiary Care Setting, Rawalpindi

Abstract

Objective: To find the relationship between the quantitative C-reactive protein and lactate as septic markers in
neonatal sepsis.
Study Design: Cross-sectional study.
Place and Duration of Study: This study was conducted at the Neonatal Intensive Care Unit of Combined
Military Hospital (CMH), Peshawar, Pakistan from March 2024 to August 2024.
Methods: Neonates (age 1 day–28 days) diagnosed with sepsis were enrolled. Patients were categorized into
two groups: Group I (Survivors) and Group II (Non-survivors). Patient's demographic details, blood cultures,
serum C-reactive protein, neutrophil counts, plasma Lactate, and outcome in terms of hospital discharge were
assessed and recorded. Data analysis was done using SPSS version 26.
Results: Of the total 136 neonates, there were 76 (55.9%) male and 60 (44.1%) female. The overall mean age
was 14.56±7.82 days. Group I had 92 (67.6%) survivors and Group II had 44 (32.4%) non-survivors. The median
value of Lactate (millimole/Liter) and C-reactive protein (milligram/deciliter) was 2.3 (IQR 1.4-5.3) and 2.1 (IQR
0.15-8.7), respectively. Survivor group (Group-I) had lower Lactate (1.9 millimole/Liter [1.2–9] than the nonsurvivor group (4.5 millimole/Liter [2.15–7.4]), P < 0.05. The prevalence of multiple organ dysfunction was
significantly higher in Group-II 82 (89.1%) than in Group-I 16 (36.4%). Based on organism causing infections
among 136 neonatal sepsis cases, the incidence of Group B Streptococcus, Escherichia coli, Listeria
monocytogenes, Coagulase-Negative Staphylococci, Staphylococcus aureus, Enterococcus species, Klebsiella
species, and Pseudomonas aeruginosa was 58 (43%), 32 (24%), 9 (7%), 7 (5%), 4 (3%), 14 (10%), 10 (7%), and 2
(1%), respectively.
Conclusion: Lactate is superior to C-reactive protein in predicting prognosis and mortality in neonatal sepsis in
the Neonatal intensive care unit. Elevated levels of lactate and C-reactive protein are primarily associated with
increased severity of neonatal sepsis, including the progression to multiple organ dysfunction syndrome
(MODS), septic shock, and poor clinical outcomes.

How to cite this: Ali F, Aqib AR, Ahmad N, Ibrahim S, Rehman M, Usman A. Comparison of Quantitative C-Reactive Protein with Blood Lactate Levels as Septic Markers in Neonatal Sepsis: A Cross-Sectional Study in a Tertiary Care Setting, Rawalpindi. Life and Science. 2025; 6(3): 310-316. doi: http://doi.org/10.37185/LnS.1.1.740