scholarly journals Early-Onset Neonatal Sepsis: Role of C-Reactive Protein, Micro-ESR, and Gastric Aspirate for Polymorphs as Screening Markers

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Sukhdeep Kaur ◽  
Kunwarpal Singh
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Capillary Tube ◽  
High Sensitivity ◽  
High Specificity ◽  
Screening Tests ◽  
Gastric Aspirate ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Sepsis Screen

Introduction. Early-onset neonatal sepsis is a major cause of morbidness and death in newborn children. Its timely diagnosis is usually a challenge in developing countries like India. Aim. To study the efficacy of C-reactive protein (CRP), micro-ESR, and gastric aspirate for polymorphs in the diagnosis of early-onset neonatal sepsis. Materials and Methods. This study included sixty term and preterm children, inborn and referred cases. The children who presented before day seven of life with clinical suspicion of sepsis or who were at high risk of developing sepsis were included. These were further investigated. Significant values for screening tests were taken as C − reactive   protein > 0.6   mg / dl , micro-ESR—after 1 hour, fall in the column of blood in capillary tube was measured, and result was taken as mm fall in 1 hr, and gastric aspirate for polymorphs > 5   polymorphs / HPF . Sepsis screen positive result was 2 or more positive tests. The statistical evaluation was done using Fisher, and ANOVA tests using SPSS 20.0 version. Results. Sixty children were included in the study with forty as the referred ones. Most of them had tachypnea (45%). CRP showed high sensitivity, whereas micro-ESR and gastric aspirate for polymorphs showed high specificity. Conclusions. Neonatal sepsis screening is required for the detection of infection as the blood culture report may not be positive in all the cases, and even if positive, the result takes few hours. CRP showed high sensitivity, whereas micro-ESR and gastric aspirate for polymorphs showed high specificity independently as well as when combined.

Sepsis Screen Questioned

PEDIATRICS ◽  
1981 ◽  
Vol 68 (1) ◽  
pp. 153-153
Author(s):  
Patrick R. Murray
Keyword(s):  
Early Diagnosis ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Neonatal Sepsis ◽  
Screening Tests ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Leukocyte Counts ◽  
Sepsis Screen

The article by Philip and Hewitt (Pediatrics 65:1036-1041, 1980) on the early diagnosis of neonatal sepsis was interesting, but their conclusions may be misleading. They demonstrated that when at least two of five screening tests were positive (band/total neutrophils, leukocyte counts, latex C-reactive protein, erythrocyte sedimentation rate (ESR), and latex haptoglobin), neonatal sepsis could be accurately predicted in 28 of 30 (93%) infants. Two or more tests were also positive for 43 of 346 (12%) infants without proven sepsis.

scholarly journals Role of C-reactive protein and gastric aspirate polymorphs in early onset neonatal sepsis

2021 ◽  
Author(s):  
Sukhdeep Kaur ◽  
Kunwar Pal Singh
Keyword(s):  
Blood Culture ◽  
Screening Tests ◽  
Resource Poor Setting ◽  
Total Leucocyte Count ◽  
Gastric Aspirate ◽  
C Reactive Protein ◽  
Predictive Values ◽  
P Values ◽  
Reactive Protein ◽  
Sepsis Screen

Background: Neonatal septicemia is a major cause of morbidity and mortality in the neonates. It presented a diagnostic challenge in the resource poor setting of most of the developing countries of world.Methods: This prospective observational study included all term and preterm babies inborn and outborn referred cases. We included neonates less than 7 days of age with clinical suspicion of sepsis. Significant values for screening tests were taken as total leucocyte count (TLC) of >25,000/<5000, C-reactive protein>0.6 mg/dl and gastric aspirate polymorphs>5 per HPF. Sepsis screen was considered positive for two or more positive tests. Blood culture was used as the gold standard. The statistical analysis was done using SPSS 22.0 version.Results: A total number of 60 subjects were included in the study with 45 (75%) as outborn neonates. Most of them presented with tachypnea followed by difficulty in feeding and lethargy. Significant p values were observed using CRP and gastric aspirate polymorphs as independent sepsis screening markers and when combined together (p<0.001).Conclusions: Sepsis screen in neonates is required for detection of infection as blood culture may be negative and even positive result takes time. CRP showed high sensitivity. Gastric aspirate cytology with its relatively high specificity and negative predictive values serves as a good screening tool to rule out neonates unaffected by sepsis. When all the three parameters were combined together, sensitivity and specificity increased to 100% and 91.67% respectively with p values of 0.001.

scholarly journals VALIDITY OF C- REACTIVE PROTEIN IN DIAGNOSIS OF NEONATAL SEPSIS.

2020 ◽  
pp. 1-4
Author(s):  
Ghongade P. G. ◽  
Khaire P. B.
Keyword(s):  
Birth Weight ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Screening Test ◽  
Treatment Strategies ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Suspected Sepsis ◽  
Adequate Treatment ◽  
Reactive Protein

Background: Neonatal sepsis with its high incidence &grave prognosis, in spite of adequate treatment with modern antibiotics, has been a challenge for all times. Optimal diagnosis and treatment strategies are difficult to define. It is essential to diagnose early with laboratory investigation like serial CRP; so that a feasible, rapid and a relatively economic method to diagnose neonatal sepsis at earliest can be instituted even at basic health care level. hence a study was planned to find out the role of CRP against blood culture in early detection of neonatal sepsis. Aim & Objective: To evaluate Validity of C-Reactive Protein as a screening test in neonatal sepsis. Material and Method: This prospective study was carried out inpaediatric dept of medical college. 100 neonates (≤ 28 days) with suspected neonatal sepsis having a birth weight of ≥ 1000 grams admitted during a period from January 2020 to March 2020 were screened primarily with C-Reactive Protein. Serial level of CRPon the day of admission,2nd ,4th ,6th ,8th& 10th day was compared with the serial blood cultureon the day of admission,8th,15th& 21st day to establish the validity of CRP as a screening test.Data analysis carried out by Percentages, Chi Square test, Sensitivity, Specificity, Positive predictive value, Negative predictive value. Results: Amongst 100neonate 76% were early neonates,65% were low birth weight,CRP was having high sensitivity & specificity(78.57%,76.74% respectively). ROC analysis showed AUC 0.8 with p<0.001.Conclusion: CRP is a good screening test & establishes its validity in diagnosing suspected sepsis.

scholarly journals Relationship between Maternal Serum C-Reactive Protein, Funisitis and Early-Onset Neonatal Sepsis

2012 ◽  
Vol 27 (6) ◽  
pp. 674 ◽  
Author(s):  
Sung Youn Lee ◽  
Kyo Hoon Park ◽  
Eun Ha Jeong ◽  
Kyung Joon Oh ◽  
Aeli Ryu ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Maternal Serum ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Increased Levels of Plasma Extracellular Heat-Shock Proteins 60 and 70 kDa Characterized Early-Onset Neonatal Sepsis

2021 ◽  
Vol 9 ◽  
Author(s):  
Arturo Alejandro Canul-Euan ◽  
Gibran Zúñiga-González ◽  
Janelly Estefania Palacios-Luna ◽  
Rolando Maida-Claros ◽  
Néstor Fabián Díaz ◽  
...  
Keyword(s):  
Heat Shock ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Early Onset ◽  
C Reactive Protein ◽  
Hsp 70 ◽  
Blood Samples ◽  
Reactive Protein ◽  
Hsp 27 ◽  
Shock Proteins

Background: Extracellular heat-shock proteins (eHsp) are highly conserved molecules that play an important role in inflammatory diseases and have been quantified in plasma from patients with infectious diseases, including sepsis. There is a constant search for dependable biochemical markers that, in combination with conventional methods, could deliver a prompt and reliable diagnosis of early-onset neonatal sepsis.Objective: We sought to assess the level of eHsp-27, eHsp-60, eHsp-70, and tumor necrosis factor-alpha (TNFα) in plasma of healthy neonates at term and infants with early-onset neonatal sepsis.Methods: This study included 34 newborns that were classified as healthy neonates at term (blood samples from the umbilical cord, n = 23) or infants with early-onset neonatal sepsis (blood samples obtained from umbilical artery by standard sterile procedures before starting a systemic antibiotic intervention, n = 11). All blood samples were centrifuged, and the plasma recovered to determine eHsp-27, eHsp-60, eHsp-70, and TNFα levels by ELISA.Results: Our results indicate that the level of eHsp-27 in healthy neonates at term was 0.045 ± 0.024 pg/ml. This value decreased 2.5-fold in infants with early-onset neonate sepsis (0.019 ± 0.006 pg/ml, p = 0.004). In contrast, the levels of eHsp-60 and eHsp-70 in healthy neonates at term were 13.69 ± 5.3 and 4.03 ± 2.6 pg/ml, respectively. These protein levels increased significantly 1.8- and 1.9-fold in the plasma of infants with early-onset neonatal sepsis (p ≤ 0.001). The level of TNFα in healthy neonates at term was 2.94 ± 0.46 pg/ml, with a 3.0-fold increase in infants with early-onset neonatal sepsis (8.96 ± 0.72 pm/ml, p ≤ 0.001). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of eHsp compared with that of C-reactive protein were 73.3, 60.0, 47.8, and 33.3%, respectively.Conclusion: This study demonstrated a consistent increase of eHsp-60 and eHsp-70 in the plasma of infants diagnosed with early-onset neonatal sepsis. These proteins showed higher sensitivity and specificity than C-reactive protein and blood culture test.

scholarly journals Haematological Parameters in Neonatal Sepsis in a Tertiary Care Centre Study

2021 ◽  
Vol 8 (13) ◽  
pp. 751-754
Author(s):  
Pruthvi D ◽  
Pavan Ramarao Kulkarni ◽  
Uma Raghavendra Jamkhandi ◽  
Shivakumar Sanganagouda Inamdar
Keyword(s):  
Blood Culture ◽  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Neonatal Septicaemia ◽  
Sepsis Screen ◽  
Sensitivity Specificity ◽  
Culture Positive

BACKGROUND Neonatal septicaemia is a bacterial infection with positive blood culture in first four weeks of life. The early sepsis screen is vital as it detects earlier and benefits the clinician to treat the infection reducing neonatal mortality and morbidity. We wanted to evaluate various haematological screening parameters and C-reactive protein (CRP) in blood culture positive neonates in sepsis. METHODS This prospective study was conducted for a period of one year. Blood samples from hundred clinically suspected neonatal septicaemia cases were subjected to aerobic culture and sepsis screen tests like C-reactive protein, erythrocyte sedimentation ratio (ESR), total WBC count, absolute neutrophil count, immature / total neutrophil count (I / T) ratio and platelet count. The culture results were correlated with the sepsis screen tests. RESULTS Of the hundred cases studied, 18 % were blood culture positive and 66 % were males. Early onset septicaemia was more common, seen in 64 % of cases than late onset septicaemia (26 %) cases. Staphylococcus aureus was the commonest organism isolated in 38.46 % of cases followed by Klebsiella pneumoniae & E. Coli. Among the haematological parameters, the positivity was best with Creactive protein (94.44 %) followed by immature & mature neutrophil ratio (I / M) (94.44 %), I / T ratio (88.88 %) and the least with absolute neutrophil count (66.0 %). Any two or more parameters were positive in 94.44 % of the subjects. CONCLUSIONS Sepsis screen has good sensitivity, specificity and is a valuable aid for early diagnosis of neonatal septicaemia. Sepsis screen is simple, cost effective, less time consuming and easy to perform. As an individual test C-reactive protein has shown highest sensitivity, specificity and is a sensitive and responsive indicator of neonatal sepsis. KEYWORDS Blood Culture, Neonatal Septicaemia, Sepsis Screen

scholarly journals Procalcitonin vs. the combination of micro-erythrocyte sedimentation rate and C-reactive protein for diagnosing neonatal bacterial sepsis

2017 ◽  
Vol 57 (4) ◽  
pp. 205
Author(s):  
Afifa Ramadanti ◽  
Renya Hiasinta ◽  
Herman Bermawi ◽  
Erial Bahar
Keyword(s):  
Sedimentation Rate ◽  
Neonatal Sepsis ◽  
Clinical Presentation ◽  
High Sensitivity ◽  
Bacterial Sepsis ◽  
C Reactive Protein ◽  
Mortality And Morbidity ◽  
Reactive Protein ◽  
Sepsis Risk ◽  
Complete Blood Counts

Background Given the high rates of mortality and morbidity in neonatal sepsis, rapid, easy-to-use, and inexpensive biomarkers with high sensitivity and specificity are needed to diagnose neonatal sepsis. Procalcitonin is often used as a predictor in identifying neonatal sepsis, but C-reactive protein (CRP) and micro-erythrocte sedimentation rate (m-ESR) may also be valid biomarkers of neonatal sepsis.Objective To compare the accuracy of procalcitonin to the combination of CRP and m-ESR, as well as to find cut-off points for the three tests, in diagnosing bacterial neonatal sepsis.Methods Subjects were neonates hospitalized from July to October 2016 in Mohammad Hoesin Hospital, Palembang with sepsis at clinical presentation and healthy neonates with sepsis risk factors. All subjects underwent complete blood counts, CRP, m-ESR, blood cultures, and  procalcitonin examinations.Results Ninety-four infants were included, of whom 26 had proven sepsis. The combined values of m-ESR and CRP had 85% sensitivity, 59% specificity, and 66% accuracy. A procalcitonin (PCT) cut-off point of 9.7ng/mL showed 100% sensitivity, 96% specificity, and 97% accuracy level, which were significantly higher than the combined values of m-ESR and CRP.Conclusion The combined values of m-ESR (13 mm/hour) - CRP (17 mg/dL) and procalcitonin alone (2ng/mL) are both valid for the diagnosis of bacterial neonatal sepsis, but the accuracy of procalcitonin at 9.7ng/mL is significantly greater. 

scholarly journals An Update on the Use of C-Reactive Protein in Early-Onset Neonatal Sepsis: Current Insights and New Tasks

Neonatology ◽  
2012 ◽  
Vol 102 (1) ◽  
pp. 25-36 ◽  
Author(s):  
Nora Hofer ◽  
Eva Zacharias ◽  
Wilhelm Müller ◽  
Bernhard Resch
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals DIAGNOSTIC VALUE OF SIMULTANEOUS MEASUREMENT OF PROCALCITONIN, INTERLEUKIN-6 AND HS CRP IN PREDICTION OF EARLY-ONSET NEONATAL SEPSIS

2012 ◽  
Vol 4 (1) ◽  
pp. e2012028 ◽  
Author(s):  
Alireza Abdollahi ◽  
Saeed Shoar ◽  
Fatemeh Nayyeri ◽  
Mamak Shariat
Keyword(s):  
Interleukin 6 ◽  
Simultaneous Measurement ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Clinical Signs ◽  
C Reactive Protein ◽  
Maternal Risk ◽  
Reactive Protein ◽  
Early Onset Sepsis ◽  
Hs Crp

Neonatal sepsis is a major cause of morbidities and mortalities mostly remarkable in the third world nations .We aimed to assess the value of simultaneous measurement of procalcitonin (PCT) and interleukin-6 (IL-6) in association with high sensitive- C reactive protein in prediction of early neonatal sepsis.We performed a follow- up study on 95 neonates who were below 12 hours (h) of age, had clinical signs of sepsis or maternal risk factors for sepsis. Neonates were assigned to 4 groups including “proven early-onset sepsis”, “clinical early-onset sepsis”, “negative infectious status”, and “uncertain infectious status”. Blood samples were obtained within the first 12 h of birth repeated between 24 hours and 36 hours of age for determination of serum levels of PCT, IL-6, high sensitivie- C Reactive Protein (hs-CRP), and white blood cell (WBC) count.On admission, neonates with sepsis had a higher WBC count, IL-6, PCT, and hs-CRP levels compared with those neonates without sepsis. This remained significant even after 12-24 hours of admission. Also, patients with clinical evidences of sepsis had a higher serum level of PCT and IL-6 within 12-24 hours after admission compared to the patients with uncertain sepsis. In final The combination of IL-6, hs-CRP, and PCT seems to be predictive in diagnosis of early onset neonatal sepsis.

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