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 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.

scholarly journals 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

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

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 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 C-reactive protein as a diagnostic marker of neonatal sepsis in association with blood culture a retrospective study at a tertiary care hospital

2021 ◽  
Vol 8 (4) ◽  
pp. 291-296
Author(s):  
Ruchi Rati ◽  
Anshu Singhal ◽  
Namita Jaggi
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Neonatal Sepsis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Inflammatory Biomarker ◽  
Reactive Protein

To evaluate the sensitivity and specificity of C-Reactive protein as a single diagnostic inflammatory biomarker of neonatal sepsis in association with the blood culture.In this study, we retrospectively reviewed the medical records of 330 neonates at a tertiary care hospital at Gurugram from Jan, 2015 to Dec, 2020. The study population included neonates &#60;1month age. Neonates meeting the IPSC criteria (Sepsis 2.0)1 and with a positive culture were considered as neonates with proven sepsis. Neonates with congenital malformations and congenital infections associated with TORCH complex were excluded from the study.Of the 330 neonates screened for sepsis, 32 (10%) had a positive blood culture with raised CRP in 69 (21%) cases. Among the 32 cases with positive blood culture, CRP identified 29 cases. The sensitivity, specificity, positive predictive value, negative predictive values of CRP were 90.6%, 86.5%, 42% and 99% respectively. The area under the curve (AUC) for the CRP ROC analysis was 0.83 with sensitivity of 90.6% and specificity of 91.6% which showed CRP usefulness as the diagnostic inflammatory biomarker of neonatal sepsis.Prematurity (53%) in neonates was the most common risk factor associated with neonatal sepsis. Klebsiella pneumoniae 11 (34%) was the most common pathogen isolated with 73% susceptibility to Ciprofloxacin.C-Reactive protein was found to have a high diagnostic value in terms of sensitivity of 90.6% and specificity of 91.6% when 0.83 is used as a cut off point for diagnosis of neonatal sepsis. Therefore, CRP could be used as diagnostic inflammatory biomarker in resource poor settings.

Concomitant Septic Arthritis in Crystal Monoarthritis

2011 ◽  
Vol 39 (1) ◽  
pp. 157-160 ◽  
Author(s):  
LITO ELECTRA PAPANICOLAS ◽  
PAUL HAKENDORF ◽  
DAVID LLEWELLYN GORDON
Keyword(s):  
Synovial Fluid ◽  
Blood Culture ◽  
Septic Arthritis ◽  
Gram Stain ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Reactive Protein ◽  
Crystal Arthritis ◽  
Clinically Significant ◽  
Wbc Count

Objective.In acute monoarthritis, the presence of crystals in synovial fluid may lead to a diagnosis of crystal arthritis (CA) before septic arthritis (SA) can be excluded by culture. We aimed to identify the frequency of coexistence of CA with SA and to compare these with regard to synovial fluid microscopy, C-reactive protein (CRP), and blood culture.Methods.We examined 1612 synovial aspirates from 2004 to 2009 retrospectively. Of these, 104 patients with clinically significant SA were identified. These were compared to 295 patients with isolated CA.Results.Five percent of joints with CA had concomitant infection. A high synovial white blood cell (WBC) count and elevated CRP (> 100 mg/l) were predictive of concomitant SA with a sensitivity of 86.4%, specificity of 48.3% and 54.6%, and negative predictive values of 98.5% and 98.7%, respectively. In patients with SA who had a blood culture, 42.5% were positive with a matching organism. SA of the shoulder had a 90% rate of bacteremia.Conclusion.Crystals alone in synovial fluid from acute monoarthritis cannot exclude SA, as CA and SA frequently coexist. High WBC counts and elevated CRP are common to both SA and CA. Blood cultures should be collected and septic arthritis considered, even when crystals are present, particularly if the shoulder is affected. The exception is when Gram stain is negative and the CRP is < 100 mg/l and joint WBC count is < 10,000/μl. In these circumstances it is very unlikely that there will be concomitant SA.

Study of C - reactive protein in neonatal sepsis

2017 ◽  
Vol 4 (3) ◽  
pp. 890
Author(s):  
Gunjan Mehrotra
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
The Body ◽  
Causative Organism ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Reactive Protein ◽  
Sensitivity Specificity

Background: Sepsis is one of the most common causes of morbidity and mortality in the newborn. Early diagnosis and treatment is vital to improve outcome. Neonatal sepsis in newborn is characterized by paucity of signs and symptoms and is due to invasion and spread through the body of non-pathogenic/ pathogenic & Gram positive / negative organism. It is subtle disease, the general characteristic of bacterial infection in neonatal period are influenced more by response of the infant than the causative organism. The present study was therefore carried out to determine the usefulness of C-reactive protein (CRP) for evaluation of neonatal sepsis in tertiary care hospital.Methods: Neonates with clinical suspicion of sepsis were prospectively studied out from June 2006 to January 2008. Blood was obtained from each subject recruited for the qualitative estimation of CRP. Blood culture was used as gold standard for diagnosis of NNS.Results: Of 50 neonates studied, 34 (68%) had positive CRP while 31 (62%) had positive blood culture. The sensitivity, specificity, positive and negative predictive values of CRP were 90.32%, 42.10%, 71.79% and 72.72% respectively.Conclusions: The qualitative method of estimating CRP which is cheap and rapid has moderate sensitivity, specificity and negative predictive value.

scholarly journals Comparison between procalcitonin and C-reactive protein to predict blood culture results in ICU patients

Critical Care ◽  
2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Matteo Bassetti ◽  
Alessandro Russo ◽  
Elda Righi ◽  
Elisabetta Dolso ◽  
Maria Merelli ◽  
...  
Keyword(s):  
Blood Culture ◽  
C Reactive Protein ◽  
Icu Patients ◽  
Reactive Protein

scholarly journals Septicemia detection by blood buffy coat smear in primary health care centers

2012 ◽  
Vol 7 (1) ◽  
pp. 19-23
Author(s):  
BK Jha ◽  
YI Singh ◽  
S Mahadevmurthy ◽  
NK Chaudhary
Keyword(s):  
Health Care ◽  
Blood Culture ◽  
Early Diagnosis ◽  
Hospital Setting ◽  
Buffy Coat ◽  
C Reactive Protein ◽  
Klebsiella Species ◽  
Reactive Protein ◽  
Primary Health Care Centers ◽  
Health Care Centers

Early diagnosis of childhood septicemia can be done by simple tests like C-reactive protein (CRP) and anticoagulant added blood centrifuged buffy coat smear (BBCS) examination, where there is no well equipped hospital setting for blood culture and identification facility in remote health care centers. This study was conducted between 1st Jan. 2007 to 27th Dec. 2007 in College of Medical Sciences, Bharatpur, Nepal. In this study we have selected 150 suspected cases of childhood septicemia for screening CRP by kit method and BBCS by two slide techniques. This kit is supplied by Span Diagnostic Pvt. Ltd. (Surat, India). Out of 150 cases of childhood septicemia of age group 0-14 years, 83 had positive C- reactive protein (CRP >6ì g/ml), 70 were positive for BBCS and blood culture was positive only in 83 cases, where predominant organism being Klebsiella species followed by Staphylococcus species. CRP test showed 100.0% sensitivity and 87.30% specificity, where BBCS showed 76.5% sensitivity and 91.2% specificity. Blood culture reports are available only after 48-72 hours and this facility is available only in well equipped centers but CRP and BBCS are easy and cheap procedure to perform even in remote areas for early diagnosis of childhood septicemia. DOI: http://dx.doi.org/10.3126/jcmsn.v7i1.5968 JCMSN 2011; 7(1): 19-23

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