ROLE OF ELECTROLYTES AND INFLAMMATORY BIOMARKERS (CRP, ESR, PROCALCITONIN AND TLC) IN DEVELOPMENT OF NEONATAL SEPTICEMIA: A CROSS-SECTIONAL STUDY

Background: Neonatal septicemia remains a major cause of morbidity and mortality worldwide, particularly in low- and middle-income countries, due to delayed diagnosis and nonspecific clinical presentation. The immature immune system of neonates limits their ability to mount an effective inflammatory response, making laboratory biomarkers essential for early detection. Inflammatory markers and electrolyte disturbances frequently accompany systemic infection, yet their combined diagnostic relevance in late-onset neonatal septicemia remains insufficiently explored in regional clinical settings. Objective: To evaluate the diagnostic significance of key inflammatory biomarkers—C-reactive protein, procalcitonin, total leukocyte count, and erythrocyte sedimentation rate—and their relationship with electrolyte imbalances in neonates with late-onset septicemia. Methods: A descriptive cross-sectional study was conducted in neonatal intensive care units of tertiary hospitals in Faisalabad, Pakistan. Fifty neonates were initially screened; thirty-five with early-onset sepsis were excluded. Fifteen neonates aged 3–28 days diagnosed with late-onset septicemia were included. Venous blood samples were analyzed for inflammatory biomarkers and serum electrolytes using standardized chemistry analyzers. Data were analyzed using SPSS, applying descriptive statistics and Pearson correlation analysis. Results: Elevated C-reactive protein levels were observed in 12 neonates (80%), while procalcitonin was raised in 11 neonates (73.3%). Total leukocyte count was elevated in 7 cases (46.7%), and erythrocyte sedimentation rate in 5 cases (33.3%). Hyponatremia was present in 8 neonates (53.3%), hypochloremia in 6 (40.0%), and potassium imbalance in 7 (46.7%). A strong positive correlation was found between C-reactive protein and procalcitonin (r = 0.899), while moderate negative correlations were observed between inflammatory markers and sodium and chloride levels. Conclusion: C-reactive protein and procalcitonin demonstrated superior diagnostic utility in late-onset neonatal septicemia. Electrolyte imbalances, particularly hyponatremia, were frequent and reflected systemic involvement. A combined assessment of inflammatory biomarkers and electrolytes may enhance early diagnosis and clinical management of neonatal sepsis.