A correlation study of c-reactive protein and platelets in neonatal sepsis

Neonatal sepsis is a life-threatening condition and a leading cause of neonatal morbidity and mortality, particularly in low- and middle-income countries. Early diagnosis is difficult due to nonspecific clinical features. Biomarkers such as C-reactive protein (CRP), total leukocyte count (TLC), and platelet count are commonly used to support diagnosis, but their relative diagnostic utility requires further evaluation. A study was conducted for the correlation between C-reactive protein and platelet count in neonatal sepsis and to assess the diagnostic accuracy of CRP, TLC, and platelet count. This prospective observational study was conducted over 18 months in a tertiary care neonatal intensive care unit. A total of 150 neonates with clinical features suggestive of sepsis and supportive laboratory evidence were included. Neonates with congenital anomalies or non-sepsis-related thrombocytopenia were excluded. Blood culture–proven sepsis was identified in 120 neonates (80%), with Gram-negative organisms predominating (74.17%), particularly Klebsiella spp. CRP was positive in 135 neonates (90%) and showed high sensitivity (95.83%) but low specificity (33.33%) for sepsis (AUC 0.87). Thrombocytopenia was observed in 76.67% of neonates and demonstrated the highest diagnostic accuracy (AUC 0.98), while TLC showed balanced sensitivity (75%) and specificity (66.67%) with an AUC of 0.92. Platelet count emerged as the most reliable single predictor of neonatal sepsis, while CRP served as a highly sensitive screening marker. A combined biomarker approach using CRP, TLC, and platelet count may significantly improve early diagnosis and management of neonatal sepsis.