C-reactive protein as a predictor of meningitis in early onset neonatal sepsis: a single unit experience

2020 ◽  
Vol 48 (8) ◽  
pp. 845-851 ◽  
Author(s):  
Naveed Ur Rehman Durrani ◽  
Sourabh Dutta ◽  
Niels Rochow ◽  
Salhab el Helou ◽  
Enas el Gouhary
Keyword(s):  
Early Onset ◽  
Neonatal Intensive Care ◽  
C Reactive Protein ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Reactive Protein ◽  
Early Onset Sepsis ◽  
Polymerase Chain ◽  
Sensitivity Specificity ◽  
Serum Crp

AbstractObjectivesTo determine whether there is a cut off value of serum C-reactive protein (CRP) associated with a higher risk of meningitis in suspected early onset sepsis (EOS) (onset birth to 7 days of life).MethodsA retrospective cohort study on neonates admitted in neonatal intensive care unit at McMaster Children’s Hospital from January 2010 to 2017 and had lumbar puncture (LP) and CRP for workup of EOS. Included subjects had either (a) non-traumatic LP or (b) traumatic LP with cerebral spinal fluid (CSF) polymerase chain reaction or gram stain or culture-positive or had received antimicrobials for 21 days. Excluded were CSF done for metabolic errors, before cytomegalovirus (CMV) treatment; from ventriculo-peritoneal (VP) shunts; missing data and contamination. Neonates were classified into definite and probable meningitis and on the range of CRP. We calculated sensitivity, specificity, and likelihood ratios for CRP values; and area under the receiver operating characteristic (AUROC) curve.ResultsOut of 609 CSF samples, 184 were eligible (28 cases of definite or probable meningitis and 156 controls). Sensitivity, specificity, predictive values, likelihood ratios, and AUROC were too low to be of clinical significance to predict meningitis in EOS.ConclusionsSerum CRP values have poor discriminatory power to distinguish between subjects with and without meningitis, in symptomatic EOS.

scholarly journals CORRELATION OF SERUM CRP & LACTATE AS AN EARLY PREDICTOR OF STRANGULATION IN ACUTE ABDOMEN

2020 ◽  
Vol 7 (2) ◽  
pp. 181-188
Author(s):  
Saleem Tahir ◽  
Samaksh Giri ◽  
Shadab Asif ◽  
Brijesh Rathore
Keyword(s):  
Acute Abdomen ◽  
Diagnostic Value ◽  
Serum Lactate ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Cutoff Value ◽  
Reactive Protein ◽  
Sensitivity Specificity ◽  
Serum Crp ◽  
Early Predictor

Strangulation in acute abdomen is one of the dangerous complication in patients of acute abdomen and early diagnosis is necessary for prevention of mortality. Present study was aimed to find whether serum C-Reactive Protein (CRP) and Serum Lactate can be used as early predictor for strangulation in cases of acute abdomen. A total of 75 patients with acute abdomen were included in the study. The serum CRP and Lactate values were measured preoperatively and correlated with intraop findings postoperatively. ROC curve was drawn and cutoff value for prediction of strangulation and mortality based on which diagnostic value was calculated. At cutoff level of 45.5 mg/L, CRP was 85.0% sensitive and 85.7% specific with positive and negative predictive values of 87.2% & 83.3% for prediction of strangulation in acute abdomen while sensitivity, specificity, PPV and NPV of Serum lactate was 100.0%, 91.4% 93.0% & 100.0% respectively using cutoff value ≥23.5mg/dl. Serum CRPand Lactate could be useful markers in predicting strangulation in cases of acute abdomen.

scholarly journals Combination of Serum C-reactive Protein and D-lactate: Predictors of Strangulation in Intestinal Obstruction

2016 ◽  
Vol 5 (3) ◽  
pp. 134-139 ◽  
Author(s):  
Ajay K Pal ◽  
Maulana M Ansari ◽  
Najmul Islam
Keyword(s):  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Acute Intestinal Obstruction ◽  
Emergency Setting ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Cutoff Value ◽  
Reactive Protein ◽  
Sensitivity Specificity ◽  
Serum Crp

ABSTRACT Introduction Serum C-reactive protein (CRP) and D-lactate have been proposed as markers of intestinal ischemia. The purpose of this prospective observational study is to find whether serum CRP and serum D-lactate can help in predicting strangulation in cases of acute intestinal obstruction. Materials and methods A total of 50 consecutive patients were included in the study after excluding patients of comorbid medical illness and patients with findings other than obstruction or strangulation. The serum values of CRP and D-lactate were measured and compared between obstruction with strangulation and obstruction without strangulation. Receiver operating characteristic (ROC) curve was drawn and cutoff values for the diagnosis of strangulation were calculated along with calculation of sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs). Results A total of 14 patients who were diagnosed with strangulated bowel obstruction had significantly higher values of serum CRP and D-lactate when compared with 36 patients with simple bowel obstruction (116 vs 40 mg/L and 5.4 vs 2.7 mmol/L respectively, p < 0.05). Using ROC analysis, the area under the curve of serum CRP and D-lactate was found to be 0.785 and 0.775 respectively, for bowel strangulation. Using a cutoff value of 60 mg/L for CRP, the sensitivity, specificity, PPV, and NPV were 87.5, 58.3, 48.3, 91.3% respectively. Using a cutoff value of 4.5 mmol/L for D-lactate, the sensitivity, specificity, PPV, and NPV were 75.0, 69.4, 52.7, 86.2% respectively. Conclusion Serum CRP and D-lactate can be useful and reasonable markers for predicting strangulation in cases of acute intestinal obstruction in an emergency setting. How to cite this article Pal AK, Ansari MM, Islam N. Combination of Serum C-reactive Protein and D-lactate: Predictors of Strangulation in Intestinal Obstruction. Panam J Trauma Crit Care Emerg Surg 2016;5(3):134-139.

Neutrophil CD64 Index as a superior biomarker for early diagnosis of infection in febrile patients in the hematology department

2017 ◽  
Vol 55 (1) ◽  
pp. 82-90 ◽  
Author(s):  
Shu-Dao Xiong ◽  
Lian-Fang Pu ◽  
Hui-Ping Wang ◽  
Lin-Hui Hu ◽  
Yang-Yang Ding ◽  
...  
Keyword(s):  
High Specificity ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Combined Analysis ◽  
Reactive Protein ◽  
Neutrophil Cd64 ◽  
Special Value ◽  
Diagnostic Values ◽  
Neutropenic Patients ◽  
Sensitivity Specificity

Abstract Background: In the hematology department, the availability of biomarkers for early detection of infection is difficult to obtain. The present study aimed to compare the diagnostic values of neutrophil CD64 Index, procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP) and to determine whether the combined analysis of these biomarkers offer stronger predictive power in the diagnosis for the infection of febrile patients. Methods: Neutrophil CD64 Index, PCT, IL-6 and CRP levels were determined in 356 febrile patients in the hematology ward from May 2013 to May 2015. Sensitivity, specificity, positive and negative likelihood ratios, positive and negative predictive values, receiver operating characteristic (ROC) areas under the curve (AUC), and logistic regression analysis were determined to evaluate the diagnostic values of these biomarkers. Results: The levels of the four biomarkers were higher in the infection patients (p<0.001), and the PCT and IL-6 were higher in the patients with positive microbial blood culture (p<0.01). The neutrophil CD64 Index, PCT, IL-6, CRP had AUCs of 0.95, 0.83, 0.75 and 0.73, respectively. The best cut-off value of the neutrophil CD64 Index to detect infections was 5.06, with high specificity (87.5%) and sensitivity (88.4%). Furthermore, neutrophil CD64 Index, PCT and IL-6 offered the best combination of diagnosis with sensitivity of 93.9% and an AUC of 0.95. In addition, the neutrophil CD64 Index may have a special value to assist the physician to diagnose infection in the neutropenic patients with fever. Conclusions: The neutrophil CD64 Index is useful for early identification of infections in febrile patients in the hematology department. The combined analysis of the CD64 Index, PCT and IL-6 could further improve its sensitivity.

scholarly journals Role Of C-Reactive Protein in Diagnosis of Acute Appendicitis

2021 ◽  
Vol 10 (4) ◽  
pp. 210-214
Author(s):  
Mirza Tassawar Hussain ◽  
Muhammad Kashif Khan ◽  
Syed Shamsuddin ◽  
Aabid Ali ◽  
Erum Khan ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
C Reactive Protein ◽  
Diagnostic Dilemma ◽  
Senior Registrar ◽  
Predictive Values ◽  
Reactive Protein ◽  
Highly Sensitive ◽  
Sensitivity Specificity

Background: Appendicitis is a common surgical emergency and diagnostic dilemma. Making the correct diagnosis is often difficult as the clinical presentation varies according to the age of the patient and the position of appendix. The objective of this study was to identify clinical applicability of C- reactive protein, as a diagnostic test for appendicitis. Methods: This prospective study was carried out in Federal government Polyclinic hospital, Islamabad from January to July 2019, 114 patients underwent appendectomy for clinically diagnosed acute appendicitis. The decision to operate the patient was given by senior registrar. The blood samples for C-reactive protein were drawn before taking the patient to the operating theatre. Removed appendices were sent for histopathological confirmation of diagnosis. The C-reactive protein was then compared with the results of histopathology to determine its validity. The data was entered and analysed in SPSS 23. Results: The sensitivity, specificity, positive and negative predictive values of C-reactive protein in patients with clinical diagnosis of acute appendicitis were found to be 94%, 78%, 93% and 74 % respectively. Conclusion: CRP is helpful in making diagnosis of acute appendicitis. It is highly sensitive but has a relatively low specificity.  

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.

Procalcitonin and Neonatal Sepsis: Is This the Biomarker We Are Looking For?

2017 ◽  
Vol 36 (6) ◽  
pp. 380-384 ◽  
Author(s):  
Susan Givens Bell
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Diagnostic Marker ◽  
C Reactive Protein ◽  
Neonatal Deaths ◽  
Live Births ◽  
Neonatal Disease ◽  
Protein Levels ◽  
Reactive Protein ◽  
Early Onset Sepsis

AbstractResearchers estimate the incidence of early onset sepsis as 0.77–1/1,000 live births. It remains as one of the leading causes of neonatal deaths. Clinicians and researchers continue to search for biomarkers for specific neonatal disease processes. Clinicians frequently trend C-reactive protein levels during evaluation for neonatal sepsis. Recently, researchers have begun to explore procalcitonin as a potentially useful diagnostic marker for neonatal sepsis.

Preoperative serum C-reactive protein concentration can be used to detect gallbladder rupture in dogs with gallbladder mucocele

2022 ◽  
pp. 1-10
Author(s):  
Makoto Asakawa ◽  
Mayuko Fukuzawa ◽  
Midori Goto Asakawa ◽  
James A. Flanders
Keyword(s):  
Medical Records ◽  
Protein Concentration ◽  
Interquartile Range ◽  
C Reactive Protein ◽  
Abdominal Ultrasonography ◽  
Reactive Protein ◽  
Preoperative Serum ◽  
Sensitivity Specificity ◽  
Serum Crp ◽  
Gallbladder Rupture

Abstract OBJECTIVE To determine whether serum C-reactive protein (CRP) concentration could be used to detect gallbladder rupture (GBR) prior to surgery in dogs undergoing cholecystectomy for treatment of gallbladder mucocele (GBM). ANIMALS 45 dogs that underwent cholecystectomy because of GBM at a companion animal referral hospital from 2017 to 2020. PROCEDURES Electronic medical records were reviewed, and dogs were included if serum CRP concentration had been measured within 24 hours prior to cholecystectomy. Dogs were grouped as to whether the gallbladder was found to be ruptured or intact during surgery. Accuracy of using preoperative CRP concentration to predict GBR was compared with accuracy of abdominal ultrasonography and other preoperative blood tests. RESULTS GBR was present in 15 dogs at the time of surgery. Median preoperative CRP concentration was significantly higher in dogs with GBR (15.1 mg/dL; interquartile range, 7.4 to 16.8 mg/dL) than in dogs with an intact gallbladder (2.65 mg/dL; interquartile range, 0.97 to 13.4 mg/dL). Sensitivity, specificity, and accuracy of using preoperative CRP concentration to predict GBR were 100%, 67%, and 78%, respectively. CLINICAL RELEVANCE Measurement of preoperative CRP concentration provided excellent sensitivity and moderate specificity for detection of GBR in dogs undergoing cholecystectomy because of GBM. Accuracy of using preoperative CRP concentration for detection of GBR was not superior to the accuracy of preoperative abdominal ultrasonography. However, when CRP concentration was combined with results of ultrasonography, the sensitivity, specificity, and accuracy for detection of GBR were 100%, 93%, and 96%, respectively.

Preterm Infants Can Mount Appropriate C-Reactive Protein Responses to Early Onset Sepsis

2015 ◽  
Vol 32 (13) ◽  
pp. 1281-1286 ◽  
Author(s):  
Sanket Shah ◽  
Ajay Talati ◽  
Mohamad Elabiad ◽  
Ramasubbareddy Dhanireddy ◽  
Massroor Pourcyrous
Keyword(s):  
Preterm Infants ◽  
Early Onset ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Early Onset Sepsis

scholarly journals C-Reactive Protein, Procalcitonin, and White Blood Count to Rule Out Neonatal Early-onset Sepsis Within 36 Hours: A Secondary Analysis of the Neonatal Procalcitonin Intervention Study

2020 ◽  
Author(s):  
Martin Stocker ◽  
Wendy van Herk ◽  
Salhab el Helou ◽  
Sourabh Dutta ◽  
Frank A B A Schuerman ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Early Onset ◽  
Blood Count ◽  
Intervention Study ◽  
Secondary Analysis ◽  
White Blood Count ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Early Onset Sepsis ◽  
Rule Out

Abstract Background Neonatal early-onset sepsis (EOS) is one of the main causes of global neonatal mortality and morbidity, and initiation of early antibiotic treatment is key. However, antibiotics may be harmful. Methods We performed a secondary analysis of results from the Neonatal Procalcitonin Intervention Study, a prospective, multicenter, randomized, controlled intervention study. The primary outcome was the diagnostic accuracy of serial measurements of C-reactive protein (CRP), procalcitonin (PCT), and white blood count (WBC) within different time windows to rule out culture-positive EOS (proven sepsis). Results We analyzed 1678 neonates with 10 899 biomarker measurements (4654 CRP, 2047 PCT, and 4198 WBC) obtained within the first 48 hours after the start of antibiotic therapy due to suspected EOS. The areas under the curve (AUC) comparing no sepsis vs proven sepsis for maximum values of CRP, PCT, and WBC within 36 hours were 0.986, 0.921, and 0.360, respectively. The AUCs for CRP and PCT increased with extended time frames up to 36 hours, but there was no further difference between start to 36 hours vs start to 48 hours. Cutoff values at 16 mg/L for CRP and 2.8 ng/L for PCT provided a sensitivity of 100% for discriminating no sepsis vs proven sepsis. Conclusions Normal serial CRP and PCT measurements within 36 hours after the start of empiric antibiotic therapy can exclude the presence of neonatal EOS with a high probability. The negative predictive values of CRP and PCT do not increase after 36 hours.

Sign in / Sign up

Export Citation Format

Share Document