Introduction: Neonatal sepsis is a serious problem that needs to be addressed for a better outcome of the neonates. This study was conducted to determine the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of C-Reactive Protein (CRP) in neonates with sepsis in comparison with blood culture. Methods: This cross-sectional study was carried out in clinically suspected neonates with sepsis in a tertiary hospital. Association between C-reactive protein and blood culture positivity in neonatal sepsis was studied. Results: Out of 245 patients admitted with clinical suspicion of sepsis, 104 (42.45%, 95% CI: 36.18-48.90%) were blood culture-proven sepsis. CRP was reactive in 92 cases (88.5%, 95% CI: 80.71 % - 93.89%) of blood culture-proven sepsis. Gram-negative organisms were predominant, 58 (57.55%) seen from the isolates of blood culture while gram-positive organisms were found to be 46 (43.23%). Early-onset sepsis was seen in 194 (79.18%) cases, while late-onset sepsis accounted for 51(20.82%). The sensitivity and specificity of CRP in the diagnosis of neonatal sepsis was 88.5% and 46.1% respectively with the positive predictive value of 54.8% and negative predictive value of 84.1% and diagnostic accuracy of 64.1%. Conclusion: Neonatal sepsis is still an important cause of hospital admission in the neonatal intensive care unit of our hospital. This study highlights the high sensitivity and negative predictive value but lower specificity and positive predictive value of CRP in relation to blood culture. The present study depicts a significant correlation between culture positivity and CRP.

Keywords: Blood culture, C- Reactive protein, Neonatal intensive care unit, Neonatal sepsis