Procalcitonin and CRP effective biomarkers of neonatal sepsis: BMJ

The key findings of this study were:

A total of 23 179 newborns were included in 134 studies that examined biomarkers in children out of 6570 total research. 

80 studies, or 59.7%, were carried out in LMICs. 

When utilizing blood culture as the reference standard in LMICs, CRP of ≥60 mg/L (AUC 0.87, 95% CI 0.76 to 0.91) among 1339 newborns and PCT of ≥0.5 ng/mL (AUC 0.87, 95% CI 0.70 to 0.92) among 617 neonates showed the highest discriminating value for the diagnosis of neonatal sepsis.

In conclusion, in LMICs, CRP and PCT provided high discriminatory value for identifying newborn sepsis. To identify newborn sepsis in LMICs, however, none of the examined biomarkers exhibited acceptable specificity or discriminatory value. Clinical prediction algorithms should include biomarkers in future research done in LMICs to provide the best possible diagnostic and discriminatory capabilities for newborn sepsis.

Reference: 

Rees, C. A., Lim, J., Westbrook, A. L., El Helou, R., Schmid, A., Rubin-Smith, J., Shreeve, K., Rotman, C., Govindapillai, S., Dorney, K., & Niescierenko, M. (2023). Systematic review and meta-analysis of the diagnostic value of four biomarkers in detecting neonatal sepsis in low- and middle-income countries. In BMJ Paediatrics Open (Vol. 7, Issue 1, p. e001627). BMJ. https://doi.org/10.1136/bmjpo-2022-001627