Prospective evaluation of the usefulness of C-reactive protein in the diagnosis of neonatal sepsis in a sub-Saharan African region

AbstractObjectivesNeonatal sepsis, a condition defined as bacteremia within the first month of life accompanied by signs of systemic infection, is the most preventable cause of infant mortality in sub-Saharan Africa. Despite the development of new infection markers, C-reactive protein (CRP) is the most extensively studied acute phase reactant so far and the preferred index in many neonatal intensive care units (NICUs). The aim of the present study was to evaluate an affordable, non-commercial turbidimetric CRP assay for monitoring early-onset neonatal sepsis (EOS).MethodsA total of 148 neonates admitted at the NICU of the Hôpital Provincial Général de Référence de Bukavu to diagnose and to monitor EOS were enrolled in the study. CRP was assayed using a functional turbidimetric assay based on the interaction of CRP with phosphocholine containing particles (Intralipid®).ResultsIn total, 62/148 (41.9%) cases were identified as blood culture-proven EOS. Different serum CRP slopes were observed among the different birth weight categories. Moreover, the serum (CRP 48 h–CRP 12 h) difference and the birth weight predicted the outcome of these septic newborns.ConclusionsOur turbidimetric CRP assay is a potential novel tool that can be used in the management of EOS in sub-Saharan Africa. The simplicity of the assay and the extremely low price make the CRP method very well suited for developing countries.

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The usefulness of C-reactive protein in predicting malaria parasitemia in a sub-Saharan African region

PLoS ONE ◽

10.1371/journal.pone.0201693 ◽

2018 ◽

Vol 13 (8) ◽

pp. e0201693 ◽

Cited By ~ 4

Author(s):

Bismark Osei Sarfo ◽

Andreas Hahn ◽

Norbert Georg Schwarz ◽

Anna Jaeger ◽

Nimako Sarpong ◽

...

Keyword(s):

C Reactive Protein ◽

African Region ◽

Reactive Protein ◽

Malaria Parasitemia ◽

Sub Saharan

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Diagnosis of neonatal sepsis in low resource settings: C-reactive protein or procalcitonin?

Journal of Pediatric Biochemistry ◽

10.1055/s-0036-1586432 ◽

2016 ◽

Vol 03 (02) ◽

pp. 079-083

Author(s):

Lawrence Mbuagbaw ◽

Francisca Monebenimp ◽

Bolaji Obadeyi ◽

Grace Bissohong ◽

Marie-Thérèse Obama ◽

...

Keyword(s):

Neonatal Sepsis ◽

C Reactive Protein ◽

Low Resource Settings ◽

Low Resource ◽

Reactive Protein

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Diagnostic Value of Cytokines and C-reactive Protein in the First 24 Hours of Neonatal Sepsis

American Journal of Perinatology ◽

10.1055/s-2003-45382 ◽

2003 ◽

Vol 20 (8) ◽

pp. 491-502 ◽

Cited By ~ 54

Keyword(s):

Neonatal Sepsis ◽

Diagnostic Value ◽

C Reactive Protein ◽

Reactive Protein

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Accuracy of leukocyte indices and C-reactive protein for diagnosis of neonatal sepsis

The Pediatric Infectious Disease Journal ◽

10.1097/00006454-199505000-00005 ◽

1995 ◽

Vol 14 (5) ◽

pp. 362-366 ◽

Cited By ~ 96

Author(s):

ORLANDO DA SILVA ◽

ARNE OHLSSON ◽

CYNTHIA KENYON

Keyword(s):

Neonatal Sepsis ◽

C Reactive Protein ◽

Reactive Protein

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

10.36106/ijsr/1506241 ◽

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.

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Role of Serial C-reactive Protein (CRP) in Relation to Total Leucocyte Count, Platelet Count & Blood Culture for early Diagnosis of Neonatal Septicemia in Developing Countries

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v32i2.26032 ◽

2015 ◽

Vol 32 (2) ◽

pp. 61-65

Author(s):

Chiranjib Barua ◽

Md Nurul Anwar ◽

Md Shahidullah ◽

Shahadat Hossain ◽

Sharmila Barua ◽

...

Keyword(s):

Developing Countries ◽

Blood Culture ◽

Early Diagnosis ◽

Neonatal Sepsis ◽

Leucocyte Count ◽

Control Group ◽

Total Leucocyte Count ◽

C Reactive Protein ◽

Neonatal Septicemia ◽

Reactive Protein

Neonatal septicemia is a clinical syndrome of systemic illness accompanied by bacteremia occuring in the first 28 days of life. Neonatal septicemia is one of the major causes of neonatal death in developing countries. Early diagnosis and treatment can prevent neonatal mortality and morbidity. The present study includes: 1) usefulness of CRP (C-reactive protein), Total Leucocyte Count, Platelet Count and Blood Culture in early diagnosis of Neonatal Sepsis, 2) significance of serial CRP in diagnosis of neonatal sepsis. 3) the prognostic value of CRP in neonatal sepsis. This is a prospective study done in neonatal ward, Chittagong Medical College Hospital and carried out from January 2008 to January 2011. Sample size was 300. One hundred fifty neonates with suspected sepsis as cases and 150 healthy babies as control were enrolled in this study. Seventy two percent of cases neonates were preterm and low birth weight. Common risk factors for neonatal septicemia which were identified in this study; preterm (72%), low birth weight (72%), premature rupture membrane (60%), chorioamnionitis (26%) and maternal urinary tract infection (16%) . Out of 150 cases of suspected neonatal sepsis total 80.7%% had raised CRP, in initial sample 70.39% were CRP positive and in 2nd sample additional 9.31% case were CRP positive . In control group 91% were CRP negative. CRP was positive in 100% of culture proven sepsis. Sensitivity of CRP was 80.67% and specificity of CRP was 76.44%. Leucocytosis was observed in 7% of cases and leucopenia was found in 11% of cases. In 82 % cases leucocyte count was found normal. In control group, 95% had normal leucocyte count and 5% had leucocytosis but no leucopenia. Sensitivity of leucocyte count was 18% and specificity was 20.68%. Thrombocytopenia was found in 28% of case group. Out of 150 cases only 15.33% yielded growth of organisms in blood culture. Klebsiella was the most common pathogen isolated which was followed by E.coli and Strph. aureus. Sensitivity of blood culture was 15.33% and specificity was 100% Therefore serial CRP can be taken as alternative method for diagnosis of neonatal sepsis specially in developing countries where blood culture is not readily available.J Bangladesh Coll Phys Surg 2014; 32: 61-65

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