Assessment of C-reactive protein, procalcitonin and interlukin-6 as diagnostic aid for neonatal infections at a tertiary care center


  • Jayesh Pandey Department of Microbiology, Santosh Medical College, Santosh Deemed to be University, Ghaziabad 201009, Uttar Pradesh, India
  • Dakshina Bisht Department of Microbiology, Santosh Medical College, Santosh Deemed to be University, Ghaziabad 201009, Uttar Pradesh, India
  • Mahima Mittal Department of Paediatrics, All India Institute of Medical Sciences, Gorakhpur, 273008, Uttar Pradesh, India
  • Amresh Kumar Singh Department of Microbiology, Baba Raghav Das Medical College, Gorakhpur 273013, Uttar Pradesh, India



Neonatal sepsis, biomarkers, procalcitonin, C-reactive protein, IL-6


Introduction and Aim:  Neonatal infections are the leading cause of mortality among neonates after prematurity.  The importance determining biological markers to be used as a diagnostic test to detect neonatal infections the in early stage of the disease is a challenge. The purpose of this study was to evaluate the usefulness & sensitivity of various serological markers such as serum Procalcitonin, C-reactive protein and chemokine IL-6 for diagnosis of neonatal infections leading to sepsis in new born infants.

Materials and Methods: This cross-sectional study was carried out among newborns admitted in neonatal intensive care unit (NICU) and meeting the selection criteria. Samples were collected for blood culture and ELISA was performed for detection of CRP, PCT & IL-6.

Results: A total of 300 newborns were included in this study from NICU of which 132 (44%) neonates was found to be blood culture positive. The most frequently isolated organisms were Klebsiella pneumoniae (26.5%), followed by Candida albicans (18.1%). In case of confirmed neonatal sepsis, significant higher levels of CRP, PCT and IL-6 were detected than in cases of probable sepsis. Serum procalcitonin levels exhibit highest sensitivity and specificity as 65.91% and 91.67% respectively.

Conclusion: Serum procalcitonin has better diagnostic utility in terms of biological marker for the diagnosis of neonatal infections than C- reactive protein and Interleukin-6.


Balaj, M., York, H. W., Sripada, K., Besnier, E., Vonen, H.D., Aravkin, A., et al., Parental education and inequalities in child mortality: a global systematic review and meta-analysis. The Lancet. 2021Aug. 398(10300): 608-620.

Golhar, S., Madhura, A., Chauhan, U., Nayak, A. Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates. Sci Medicine Journal. 2021 Sep 1; 3(3): 257-264.

Nesa, A., Yesmin, F., Muttalib, M. A. Biochemical and immunological markers for the early diagnosis of neonatal septicaemia. Bangladesh Medical Research Council Bulletin. 2020 Aug 1; 46(2): 83-89.

Simonsen, K., Anderson-Berry, A., Delair, S., Davies, D. Sepsis neonatal de inicio temprano. Revisiones clínicas de microbiología. 2016; 27(1): 21-47.

Nargis, W., Ibrahim, M. D., Ahamed, B. U. Procalcitonin versus C-reactive protein: Usefulness as biomarker of sepsis in ICU patient. International journal of critical illness and injury science. 2014 Jul; 4(3): 195.

Brown, J. V., Meader, N., Wright, K., Cleminson, J., McGuire, W. Assessment of C-reactive protein diagnostic test accuracy for late-onset infection in newborn infants: a systematic review and meta-analysis. JAMA pediatrics. 2020 Mar 1; 174(3): 260-268.

Assicot, M., Bohuon, C., Gendrel, D., Raymond, J., Carsin, H., Guilbaud, J. High serum procalcitonin concentrations in patients with sepsis and infection. The Lancet. 1993 Feb 27; 341(8844): 515-518.

Reis Machado, J., Soave, D. F., da Silva, M. V., de Menezes, L. B., Etchebehere, R. M., Monteiro, M. L., et al., Neonatal sepsis and inflammatory mediators. Mediators of inflammation. 2014 Dec 30; 2014.

Sonawane, V. B., Mehkarkar, N., Gaikwad, S., Kadam, N. Comparison between sepsis markers and blood culture in diagnosis of neonatal sepsis: a prospective study. Int J Res Med Sci. 2017 Mar 28; 5(4): 1662-1666.

Dhanalakshmi, V., Sivakumar, E. S. Comparative study in early neonates with septicemia by blood culture, staining techniques and c–reactive protein (CRP). Journal of clinical and diagnostic research: JCDR. 2015 Mar;9(3): DC12.

Chiesa, C., Panero, A., Osborn, J. F., Simonetti, A. F., Pacifico, L. Diagnosis of neonatal sepsis: a clinical and laboratory challenge. Clinical chemistry. 2004 Feb 1; 50(2): 279-287.

Messbarger, N., Neemann, K. Role of anaerobic blood cultures in neonatal bacteremia. Journal of the Pediatric Infectious Diseases Society. 2018 Aug 17; 7(3): e65-e69.

Nassar, M. S., Hazzah, W. A., Bakr, W. M. Evaluation of antibiotic susceptibility test results: how guilty a laboratory could be? Journal of the Egyptian Public Health Association. 2019 Dec; 94(1): 1-5.

Rath, S., Panda, S. K., Nayak, M. K., Pradhan, D.D. Blood culture positive sepsis and sensitivity pattern in a tertiary care neonatal center in eastern India. Int J Contemp Pediatr. 2019 Mar; 6(2): 487-490.

Rashwan, N. I., Hassan, M. H., El-Deen, Z. M., Ahmed, A. E. Validity of biomarkers in screening for neonatal sepsis–A single center–hospital-based study. Pediatrics & Neonatology. 2019 Apr 1; 60(2): 149-155.

Abd Elmouttaleb, A. T., Aly, H. A., Bayomy, E. M., Abdelhamed, M. R., Esmael, N. F. Plasma procalcitonin and proadrenomedullin concentrations as predictive markers for early onset neonatal sepsis. Am J Biochem. 2016; 6(1): 6-15.

Chowdhary, P., Ranjan, R., Pandey, A. Diagnostic role of interleukin-6 and quantitative C-reactive protein in suspected early onset neonatal sepsis. World Journal of Advanced Research and Reviews. 2020; 8(1): 263-270.

Morad, E. A., Rabie, R. A., Almalky, M. A., Gebriel, M. G. Evaluation of procalcitonin, C-reactive protein, and interleukin-6 as early markers for diagnosis of neonatal sepsis. International Journal of Microbiology. 2020 Oct 1; 2020: 8889086. doi: 10.1155/2020/8889086.

Noor, M. K., Shahidullah, M., Mutanabbi, M., Barua, C., Mannan, M. A., Afroza, S. Comparison between CRP and IL-6 as early markers of neonatal sepsis. Mymensingh medical journal: MMJ. 2008 Jul 1; 17(2 Suppl): S72-S76.

Adib, M., Navaei, F., Bakhshiani, Z., Saheb, F. F., Tavakoli, A., Ostadi, V. Evaluation of interleukin-6 or early diagnosis of neonatal sepsis in comparison with CRP. JIMS 2006; 24: 1-7.

Kocabas, E., Sarikcioglu, A., Aksaray, N., Seydaoglu, G., Seyhun, Y., Yaman, A. Role of procalcitonin, C-reactive protein, interleukin-6, interleukin-8 and tumor necrosis factor-alpha in the diagnosis of neonatal sepsis. Turkish Journal of Pediatrics. 2007 Jan 1; 49(1): 7.

Qu, J., Lü, X., Liu, Y., Wang, X. Evaluation of procalcitonin, C-reactive protein, interleukin-6 and serum amyloid A as diagnostic biomarkers of bacterial infection in febrile patients. The Indian Journal of mMedical Research. 2015 Mar; 141(3): 315.

Al-Zahrani, A. K., Ghonaim, M. M., Hussein, Y. M., Eed, E. M., Khalifa, A. S., Dorgham, L. S. Evaluation of recent methods versus conventional methods for diagnosis of early-onset neonatal sepsis. The Journal of Infection in Developing Countries. 2015 Mar 15; 9(04): 388-393.

Hasan, F., Khan, S. A., Maharoof, M. K., Muhammed, N. Role of procalcitonin in early diagnosis of neonatal sepsis. International Journal of Contemporary Pediatrics. 2017 Mar; 4(2): 7.

Sharma, S., Duggal, N. Role of procalcitonin, Il-6 and C-reactive protein in suspected cases of sepsis. Indian Journal of Pathology and Microbiology. 2019 Oct 1; 62(4): 578.




How to Cite

Pandey J, Bisht D, Mittal M, Singh AK. Assessment of C-reactive protein, procalcitonin and interlukin-6 as diagnostic aid for neonatal infections at a tertiary care center. Biomedicine [Internet]. 2021Dec.31 [cited 2022Jan.20];41(4):805-10. Available from:



Original Research Articles