scholarly journals Cord C-reactive protein as a marker for early onset neonatal sepsis children

2017 ◽  
Vol 4 (2) ◽  
pp. 527 ◽  
Author(s):  
Reeba Patrick ◽  
Aswathy Rajan ◽  
Ashvij Shriyan
Keyword(s):  
Birth Weight ◽  
Predictive Value ◽  
Early Onset ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
C Reactive Protein ◽  
Neonatal Deaths ◽  
Reactive Protein ◽  
Early Onset Sepsis ◽  
The Mean

Background: Of the 2.8 million neonatal deaths, worldwide, 0.43 million is contributed by sepsis alone. The objective of this study was to determine the levels of umbilical cord C-reactive protein and assess the suitability of this test in diagnosing early onset sepsis in newborns born to mothers with no risk factors for intrapartum infection. To determine the influence of other factors such as parity, birth weight and mode of delivery on the levels of cord CRP.Methods: CRP levels in cord blood were estimated for 103 consecutive newborns delivered at a tertiary care teaching hospital. These babies were monitored for signs of sepsis for 72 hours and were later followed up with serum CRP and blood cultures.Results: A prospective cohort study of 103 consecutive newborns were taken of which 53.4% were male babies. Comparison of cord CRP levels of baseline characteristics revealed significant elevation in babies born to multipara mothers (p = 0.0028) and in low birth weight babies (p = 0.05), while there were no significant changes in different modes of delivery. The mean cord CRP of the study group was 0.694±0.2979. Out of 104 babies, 16 had elevated cord CRP (above 1.1mg/l) of these, 12 babies were later confirmed to have sepsis. The mean cord CRP level in babies with EOS was 1.3±0.255 (p = 0.001). A sensitivity of 100%, specificity of 90.9%, positive predictive value of 75% and negative predictive value of 100% was determined.Conclusions: This study confirms that cord CRP is an effective marker to predict EONS. An optimal concentration of cord CRP > 1.1 mg/L has maximal sensitivity and specificity to predict EONS.

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.

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 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 Clinico-epidemiological spectrum of early onset neonatal sepsis in neonates admitted in NICU of a tertiary care institute

2019 ◽  
Vol 6 (3) ◽  
pp. 1046
Author(s):  
Ashwani Kumar ◽  
Gursharan Singh Narang ◽  
Gurmeet Singh ◽  
Navneet Virk ◽  
Ashiana Singh
Keyword(s):  
Staphylococcus Aureus ◽  
Respiratory Distress ◽  
Acinetobacter Baumannii ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Total Leukocyte Count ◽  
Early Onset Sepsis

Background: Neonatal  sepsis  is  a  clinical syndrome  characterized by signs and symptoms  of  infection  with  or  without  accompanying  bacteremia  in  the  first  month  of  life. Neonatal  sepsis  may  be  classified  into  two  groups : early onset  sepsis and  late onset  sepsis . Early onset neonatal sepsis  is  generally  associated  with  the  acquisition  of  microorganisms  from  the  mother  and  usually  presents  with  respiratory  distress  and  pneumonia.Methods: The study included one hundred  term  neonates with early onset neonatal sepsis. A septic screen including total leukocyte count, absolute neutrophil count, blood smear evaluation, blood cultures and C-reactive protein (CRP) were performed in all neonates with suspected sepsis to corroborate early onset sepsis diagnosis. Epidemiological parameters including gender of the neonate, mode of delivery, rural/urban residence were recorded in addition to clinical profile.Results: Respiratory distress was the most common presentation in the form of tachypnea, seen in 63 (63.0%) neonates. In present study, Staphylococcus aureus was the most common organism isolated followed by Staphylococcus epidermidis, Staphylococcus hominis, Acinetobacter baumannii and Klebsiella pneumonae.Conclusions: Early onset neonatal sepsis  was seen more in males. Among the gram-positive Staphylococcus aureus and among gram negative Acinetobacter baumannii and Klebsiella pneumonae were most common organisms to be isolated.

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.

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

The Predictive Value of Procalcitonin and High-Sensitivity C-Reactive Protein for Early Bacterial Infections in Preterm Neonates

Neonatology ◽  
2020 ◽  
Vol 118 (1) ◽  
pp. 28-36
Author(s):  
Tetsuo Naramura ◽  
Hiroko Imamura ◽  
Hidetaka Yoshimatsu ◽  
Kaname Hirashima ◽  
Shinji Irie ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Predictive Value ◽  
Early Onset ◽  
Bacterial Infections ◽  
High Sensitivity ◽  
Preterm Neonates ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Hs Crp

<b><i>Introduction:</i></b> Evidence on the reliability of using procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP) as diagnostic markers for early-onset neonatal bacterial infections is still insufficient because of their physiological elevation during the early neonatal period. This study aimed to assess the respiratory influence of serum PCT and hs-CRP levels and evaluate their predictive value for bacterial infections during the first 72 h of life in preterm neonates. <b><i>Methods:</i></b> The preterm neonates enrolled in this single-center retrospective cohort study were categorized into 3 groups: reference, infection-unlikely respiratory failure, and probable bacterial infection; their serum PCT and hs-CRP levels were assessed. Subsequently, age-specific 95th percentile curves were plotted and the median and cutoff PCT and hs-CRP levels for predicting bacterial infections at birth and 7–18, 19–36, and 37–72 h after birth were determined. Moreover, the analysis of PCT and hs-CRP with a neonatal sequential organ failure assessment (nSOFA) score was performed in very low birth weight neonates. <b><i>Results:</i></b> Serum PCT levels were influenced by respiratory failure. A significant difference was found in the median PCT and hs-CRP levels among the 3 groups at each time point. PCT sensitivities for predicting bacterial infection were slightly higher than those of hs-CRP in each time frame during the first 72 h of life. In both PCT and hs-CRP, there was no significant difference between infants with nSOFA scores of &#x3e;4 and those with nSOFA scores of ≤4. <b><i>Discussion/Conclusion:</i></b> Age-specific evaluation showed that PCT has better predictive value than hs-CRP for early-onset bacterial infections in preterm neonates.

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.

scholarly journals Immature to total neutrophil ratio as an early indicator of early neonatal sepsis

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Erum Saboohi ◽  
Farhan Saeed ◽  
Rashid Naseem Khan ◽  
Muhammad Athar Khan
Keyword(s):  
Negative Predictive Value ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Early Onset ◽  
Hematological Parameter ◽  
Early Indicator ◽  
Early Onset Sepsis ◽  
The Mean ◽  
Early Neonatal Sepsis

Background & Objectives: Neonatal septicemia is responsible for 1.5 to 2.0 million deaths/year in the under developed countries of the world. Pakistan is number three among these countries and accounts for 7% of global neonatal deaths. The objective of the study was to determine the role of simple hematological parameter, immature to total neutrophil ratio (I/T ratio) in diagnosing early onset neonatal bacterial infection. Methods: A descriptive cross-sectional study was conducted in Neonatal Intensive Care Unit of Liaquat College of Medicine & Dentistry (LCMD) Hospital from January 2016 to January 2017. A total 85 neonates were admitted with clinical suspicion of presumed early onset sepsis or who had potential risk factors for sepsis like prematurity, prolonged rupture of membranes was carried out. After taking informed consent from parents of admitted neonates, data was collected in a structured questionnaire. Laboratory workup included White blood cell count, CRP, absolute neutrophil count, immature neutrophil count while blood C/S was kept as gold standard. Empirical antibiotics started after sample collection for workup. Manual differential count and immature neutrophil count of the peripheral blood smear was performed by a senior technician masked to clinical information. I/T ratio was calculated from WBC, neutrophils and immature neutrophil count by a simple formula. Results: Out of 85 neonates, 13 had positive blood cultures (15.29%). The mean white blood count was 18761.18 ± 8570.75 and mean I/T ratio was 0.1622 ± 0.0419.About 50% of proven sepsis cases had WBC higher than 26000 as compared to 50% of cases for negative diagnoses that had WBC <15500 . The mean I/T in positive CRP 0.204 ± 0.04 was non-significantly higher as compared to negative CRP 0.151 ± 0.034 (p =0.084). Point biserial correlation revealed that I/T ratio was significant strong correlation (rpb = 0.721, p < 0.001) and overall I/T ratio was a good indicator of a positive and negative blood culture result. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of I/T ratio were 76.47%, 83.82%, 54.16% and 93.44% respectively. Similarly majority of neonates having high I/T ratio also depicts positive C-reactive protein (CRP) (NPV 91.23%). Therefore, both I/T and CRP showed a high negative predictive value (I/T = 93.44% and CRP = 91.23%) in this study. Conclusion: I/T ratio is a useful tool for early onset sepsis (EOS) with reasonable specificity but cannot be relied upon as sole indicator. Combination of normal immature to total neutrophil Ratio with negative CRP values in neonates with presumed sepsis is an indicator of non-infected neonate which comprised 78.8% of our study population. How to cite this:Saboohi E, Saeed F, Khan RN, Khan MA. Immature to total neutrophil ratio as an early indicator of early neonatal sepsis. Pak J Med Sci. 2019;35(1):241-246. doi: https://doi.org/10.12669/pjms.35.1.99 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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