Evaluating Neonatal CPR Diagnostic Accuracy
DOI:
https://doi.org/10.70411/MJHAS.3.2.2026378الكلمات المفتاحية:
Neonatal sepsis، C-reactive protein، Diagnostic accuracy، Blood culture، Neonatal intensive care unit، Biomarkersالملخص
Improving clinical outcomes in pediatric care requires the integration of age-appropriate diagnostic and therapeutic interventions. This study aims to evaluate the diagnostic accuracy of CPR among neonates at El-Sewedy Hospital, providing localised evidence to improve the speed and precision of sepsis management in Khartoum. This observational, hospital-based, retrospective cross-sectional study was conducted at the Neonatal Intensive Care Unit of El-Sewedy Pediatric Charity Hospital in Khartoum, Sudan, from January 2022 to January 2023. A convenience sample of 182 neonates (age 28 days and less) with confirmed sepsis was selected, and data regarding demographics, clinical risk factors, and laboratory findings were extracted using a structured form. Data were analysed using SPSS 25.0 with descriptive statistics and bivariate analysis (Chi-square and t-tests), with significance set at a p-value of 0.05 and less. The study secured ethical approval from the Sudan Medical Specialization Board, ensuring data anonymity and confidentiality.The study cohort was predominantly male (57.7%) and preterm (58.2%). The study results showed a 12.1% mortality rate. A significant majority exhibited low birth weight, with very low birth weight (VLBW) being the most common (36.3%). Maternal comorbidities were present in 44% of cases, with urinary tract infections (12.6%) and diabetes (7.6%) being the most frequent. The primary clinical presentations included respiratory distress (69.8%), dysthermia (62.6%), pyrexia (25.2%), and feeding intolerance (20.3%). Other significant findings included hyperbilirubinemia and glycemic instability (both 52.2%). In Khartoum, preterm and low-birth-weight infants face the highest risk of sepsis. Using C-Reactive Protein (CRP) within the Symptoms-Based Score (SBS) React framework provides a fast and reliable diagnostic link to clinical symptoms.
المراجع
Ahmed, I., Mergany, E., Alfadil, S., Abdelnour, H., Bleedy, N., & Almalty, A. (2025). Awareness and Experience of Physiotherapy Role in Urinary Incontinence. Saudi Journal of Nursing and Health Care, 8, 301–307. https://doi.org/10.36348/sjnhc.2025.v08i12.003
Beltempo, M., Viel-Thériault, I., Thibeault, R., Julien, A.-S., & Piedboeuf, B. (2018). C-reactive protein for late-onset sepsis diagnosis in very low birth weight infants. BMC Pediatrics, 18(1), 16. https://doi.org/10.1186/s12887-018-1002-5
Braima, O., Ali, M., & Abdulla, E. (2021). Bacteriological profile and antibiotic resistance in newborn infants with possible community-acquired neonatal sepsis in Khartoum State, Sudan. Sudanese Journal of Paediatrics, 13–22. https://doi.org/10.24911/SJP.106-1601909519
Celik, I. H., Hanna, M., Canpolat, F. E., & Mohan Pammi. (2022). Diagnosis of neonatal sepsis: The past, present and future. Pediatric Research, 91(2), 337–350. https://doi.org/10.1038/s41390-021-01696-z
Chevalier, J. M., Hansen, M. A., Grantz, K. H., Gleeson, B., Blumel, B., Chuchu, V., Khan, S., Sigwebela, N., Chimhini, G., Fitzgerald, F., Ferreyra, C., & Nichols, B. E. (2025). Potential Health and Cost Impacts of a Point-of-Care Test for Neonatal Sepsis and Possible Serious Bacterial Infections in Infants: A Modeling Analysis in Two Settings. Open Forum Infectious Diseases, 12(11), ofaf652. https://doi.org/10.1093/ofid/ofaf652
Coetzee, M., Mbowane, N., & De Witt, T. (2017). Neonatal sepsis: Highlighting the principles of diagnosis and management. South African Journal of Child Health, 11(2), 99. https://doi.org/10.7196/SAJCH.2017.v11i2.1244
Cosovanu, E. T., Cosovanu, E. O., Ionescu, S. G., Asaftei, A., Damian, C., Asaftei-Titianu, G. S., Donos, M. A., Petroaie, A. D., Ioniuc, I. K., Petris, O. R., Coman, E. A., Iancu, L. S., Caruntu, I. D., & Ursu, R. G. (2026). Diagnosing Neonatal Sepsis: A Comprehensive Review of Conventional Culture, Molecular Methods, and Host-Response Biomarkers. Acta Microbiologica Hellenica, 71(3), 28. https://doi.org/10.3390/amh71030028
De Rose, D. U., Ronchetti, M. P., Martini, L., Rechichi, J., Iannetta, M., Dotta, A., & Auriti, C. (2024). Diagnosis and Management of Neonatal Bacterial Sepsis: Current Challenges and Future Perspectives. Tropical Medicine and Infectious Disease, 9(9), 199. https://doi.org/10.3390/tropicalmed9090199
Eichberger, J., Resch, E., & Resch, B. (2022). Diagnosis of Neonatal Sepsis: The Role of Inflammatory Markers. Frontiers in Pediatrics, 10, 840288. https://doi.org/10.3389/fped.2022.840288
Emokpae, U. O., Emokpae, A., & Olajuyigbe, O. O. (2025). Evaluation of Procalcitonin and C-Reactive Protein as an Early Marker for the Diagnosis of Neonatal Sepsis. Journal of Advances in Microbiology, 25(10), 60–67. https://doi.org/10.9734/jamb/2025/v25i101004
Fleischmann-Struzek, C., Goldfarb, D. M., Schlattmann, P., Schlapbach, L. J., Reinhart, K., & Kissoon, N. (2018). The global burden of paediatric and neonatal sepsis: A systematic review. The Lancet Respiratory Medicine, 6(3), 223–230. https://doi.org/10.1016/S2213-2600(18)30063-8
Folgori, L., & Bielicki, J. (2019). Future Challenges in Pediatric and Neonatal Sepsis: Emerging Pathogens and Antimicrobial Resistance. Journal of Pediatric Intensive Care, 08(01), 017–024. https://doi.org/10.1055/s-0038-1677535
Gilfillan, M., & Bhandari, V. (2019). Neonatal sepsis biomarkers: Where are we now? Research and Reports in Neonatology, Volume 9, 9–20. https://doi.org/10.2147/RRN.S163082
Gkentzi, D., & Dimitriou, G. (2019). Antimicrobial Stewardship in the Neonatal Intensive Care Unit: An Update. Current Pediatric Reviews, 15(1), 47–52. https://doi.org/10.2174/1573396315666190118101953
Hofer, N., Zacharias, E., Müller, W., & Resch, B. (2012). An Update on the Use of C-Reactive Protein in Early-Onset Neonatal Sepsis: Current Insights and New Tasks. Neonatology, 102(1), 25–36. https://doi.org/10.1159/000336629
Iroh Tam, P.-Y., & Bendel, C. M. (2017). Diagnostics for neonatal sepsis: Current approaches and future directions. Pediatric Research, 82(4), 574–583. https://doi.org/10.1038/pr.2017.134
Kariniotaki, C., Thomou, C., Gkentzi, D., Panteris, E., Dimitriou, G., & Hatzidaki, E. (2024). Neonatal Sepsis: A Comprehensive Review. Antibiotics, 14(1), 6. https://doi.org/10.3390/antibiotics14010006
Kelly, L. A., Branagan, A., Semova, G., & Molloy, E. J. (2023). Sex differences in neonatal brain injury and inflammation. Frontiers in Immunology, 14, 1243364. https://doi.org/10.3389/fimmu.2023.1243364
Klingenberg, C., Kornelisse, R. F., Buonocore, G., Maier, R. F., & Stocker, M. (2018). Culture-Negative Early-Onset Neonatal Sepsis—At the Crossroad Between Efficient Sepsis Care and Antimicrobial Stewardship. Frontiers in Pediatrics, 6, 285. https://doi.org/10.3389/fped.2018.00285
Lekić, E., Babović, S., Vukićević, J., Nešović, M., & Dragaš, L. (2019). Early-onset neonatal sepsis and risk factors in the preterm infants. Perinat J, 27, 143–149.
Liberati, C., Brigadoi, G., Barbieri, E., Giaquinto, C., & Donà, D. (2025). Antimicrobial Stewardship Programs in Pediatric Intensive Care Units: A Systematic Scoping Review. Antibiotics, 14(2), 130. https://doi.org/10.3390/antibiotics14020130
McGovern, M., Kelly, L., Finnegan, R., McGrath, R., Kelleher, J., El-Khuffash, A., Murphy, J., Greene, C. M., & Molloy, E. J. (2024). Gender and sex hormone effects on neonatal innate immune function. The Journal of Maternal-Fetal & Neonatal Medicine, 37(1), 2334850. https://doi.org/10.1080/14767058.2024.2334850
Mohammed, F. E. A., Viva, M. I. F., Awadalla, W. A. G., Elmahi, O. K. O., Wainstock, D., & Patil, P. (2023). Defending the right to health during Sudan’s civil war. The Lancet Global Health, 11(9), e1327–e1328. https://doi.org/10.1016/S2214-109X(23)00300-5
Murless-Collins, S., Kawaza, K., Salim, N., Molyneux, E. M., Chiume, M., Aluvaala, J., Macharia, W. M., Ezeaka, V. C., Odedere, O., Shamba, D., Tillya, R., Penzias, R. E., Ezenwa, B. N., Ohuma, E. O., Cross, J. H., Lawn, J. E., the NEST360 Infection Group, Bokea, H., Bohne, C., … Palamountain, K. (2023). Blood culture versus antibiotic use for neonatal inpatients in 61 hospitals implementing with the NEST360 Alliance in Kenya, Malawi, Nigeria, and Tanzania: A cross-sectional study. BMC Pediatrics, 23(S2), 568. https://doi.org/10.1186/s12887-023-04343-0
Özmeral Odabaşı, I. (2020). Neonatal Sepsis. SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital. https://doi.org/10.14744/SEMB.2020.00236
Popescu, C. R., Cavanagh, M. M. M., Tembo, B., Chiume, M., Lufesi, N., Goldfarb, D. M., Kissoon, N., & Lavoie, P. M. (2020). Neonatal sepsis in low-income countries: Epidemiology, diagnosis and prevention. Expert Review of Anti-Infective Therapy, 18(5), 443–452. https://doi.org/10.1080/14787210.2020.1732818
Rallis, D., Giapros, V., Serbis, A., Kosmeri, C., & Baltogianni, M. (2023). Fighting Antimicrobial Resistance in Neonatal Intensive Care Units: Rational Use of Antibiotics in Neonatal Sepsis. Antibiotics, 12(3), 508. https://doi.org/10.3390/antibiotics12030508
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. BMJ Paediatrics Open, 7(1), e001627. https://doi.org/10.1136/bmjpo-2022-001627
Sarafidis, K. (2023). Special Issue “Recent Advances in Neonatal Sepsis”. Journal of Clinical Medicine, 12(4), 1385. https://doi.org/10.3390/jcm12041385
Sarkar, S., Bhagat, I., Bhatt-Mehta, V., & Sarkar, S. (2014). Does Maternal Intrapartum Antibiotic Treatment Prolong the Incubation Time Required for Blood Cultures to Become Positive for Infants with Early-Onset Sepsis? American Journal of Perinatology, 32(04), 357–362. https://doi.org/10.1055/s-0034-1387933
Satti, L., Abdelnour, H., Yousif, B., Mustafa, O., & Mohammed, R. (2025). Text neck syndrome among students at the National University in Sudan. World J Adv Res Rev, 28(3), 1501–1507.
Seale, A. C., Blencowe, H., Manu, A. A., Nair, H., Bahl, R., Qazi, S. A., Zaidi, A. K., Berkley, J. A., Cousens, S. N., & Lawn, J. E. (2014). Estimates of possible severe bacterial infection in neonates in sub-Saharan Africa, south Asia, and Latin America for 2012: A systematic review and meta-analysis. The Lancet Infectious Diseases, 14(8), 731–741. https://doi.org/10.1016/S1473-3099(14)70804-7
Seale, A. C., Blencowe, H., Zaidi, A., Ganatra, H., Syed, S., Engmann, C., Newton, C. R., Vergnano, S., Stoll, B. J., Cousens, S. N., & Lawn, J. E. (2013). Neonatal severe bacterial infection impairment estimates in South Asia, sub-Saharan Africa, and Latin America for 2010. Pediatric Research, 74(S1), 73–85. https://doi.org/10.1038/pr.2013.207
Sturrock, S., Sadoo, S., Nanyunja, C., & Le Doare, K. (2023). Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and Recommendations. Research and Reports in Tropical Medicine, Volume 14, 121–134. https://doi.org/10.2147/RRTM.S410785
Tumuhamye, J., Sommerfelt, H., Bwanga, F., Ndeezi, G., Mukunya, D., Napyo, A., Nankabirwa, V., & Tumwine, J. K. (2020). Neonatal sepsis at Mulago national referral hospital in Uganda: Etiology, antimicrobial resistance, associated factors and case fatality risk. PLOS ONE, 15(8), e0237085. https://doi.org/10.1371/journal.pone.0237085
Wong, D. M., Ruby, R. E., Dembek, K. A., Barr, B. S., Reuss, S. M., Magdesian, K. G., Olsen, E., Burns, T., Slovis, N. M., & Wilkins, P. A. (2018). Evaluation of updated sepsis scoring systems and systemic inflammatory response syndrome criteria and their association with sepsis in equine neonates. Journal of Veterinary Internal Medicine, 32(3), 1185–1193. https://doi.org/10.1111/jvim.15087
World Health Organization. (2024). Networks of care for maternal and newborn health: Implementation guidance. World Health Organization.
التنزيلات
منشور
إصدار
القسم
الرخصة
الحقوق الفكرية (c) 2026 Modern Journal of Health and Applied Sciences
هذا العمل مرخص بموجب Creative Commons Attribution-NonCommercial 4.0 International License.
The users are free to:
- Share — copy and redistribute the material in any medium or format.
- Adapt — remix, transform, and build upon the material.
The licensor cannot revoke these freedoms as long as you follow the license terms.
