C-Reactive Protein in Neonatal Sepsis

2008 ◽  
Vol 27 (2) ◽  
pp. 117-120 ◽  
Author(s):  
Michelle Hawk
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Complete Blood Count ◽  
Length Of Hospital Stay ◽  
Acute Phase Reactant ◽  
Definitive Diagnosis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
High Negative Predictive Value ◽  
Sepsis Marker

SEPSIS IS ONE OF THE MOST COMMON diagnostic challenges in the NICU. Currently a definitive diagnosis can be made only with the gold-standard blood culture, which is generally not available for 48 hours.1,2 Difficulty obtaining a large enough sample to detect a positive blood culture, as well as increased use of antenatal antibiotics, has complicated the ability to make a definitive diagnosis of sepsis.3 If left untreated, sepsis can increase morbidity and mortality. Therefore, many infants are treated empirically with broad-spectrum antibiotics.4,5 Two kinds of tests would be most helpful in the diagnosis of neonatal sepsis: one that quickly confirms the diagnosis and one that conclusively rules it out. In fact, a diagnostic sepsis marker with a high negative predictive value (the value representing patients without sepsis who are correctly diagnosed) might reduce the short- and long-term adverse effects of antibiotics, health care costs, and length of hospital stay.6 Despite extensive investigation no single test meets the criteria that would make it an ideal marker for the early diagnosis of sepsis in the newborn.5,7,8 Generally, screening includes a complete blood count with differential and may be accompanied by other adjunctive tests such as a C-reactive protein (CRP).9–11 This column examines CRP, an acute phase reactant (APR), as a diagnostic marker for neonatal sepsis.

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

TLR2 and TLR4 expressions in late-onset neonatal sepsis: Is it a potential novel biomarker?

2020 ◽  
pp. 1-7
Author(s):  
R. Rohsiswatmo ◽  
M. Azharry ◽  
T.T. Sari ◽  
Y. Bahasoan ◽  
D. Wulandari
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Complete Blood Count ◽  
Late Onset ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Tlr4 Expression ◽  
Cross Sectional ◽  
Reactive Protein

BACKGROUND: Late-onset neonatal sepsis (LONS) detection is problematic as no single examinations (blood culture, c-reactive protein (CRP), procalcitonin (PCT)) are reliable. Toll-like receptors (TLRs), which detect the presence of pathogen-associated molecular patterns is a promising novel biomarker, but less studied in LONS. This study aimed to determine neutrophils and monocytes TLR2 and TLR4 expression in LONS and their diagnostic value. METHODS: A cross-sectional study conducted in May and June 2017 involving 52 neonates with clinical late-onset (>72 hours of age) sepsis. We examine complete blood count, I/T ratio, CRP, PCT, as well as TLR2 and TLR4 expression to compared with blood culture as the gold standard. We classified cases into proven or unproven sepsis. RESULT: The incidence of LONS was 32.6% in the subjects. The expression of TLR2 was low in LONS, while TLR4 was high. TLR4 neutrophil expression has 88.2% sensitivity, 20% specificity, 34.9% positive predictive value (PPV), 77.8% negative predictive value (NPV), and an AUC of 0.541. TLR4 monocyte expression has 92.1% sensitivity, 11.4% specificity, 34% PPV, 80% NPV, and an AUC of 0.528. The AUC of CRP is increased from 0.608 to 0.843 after combination with TLR4, comparable with CRP + PCT (AUC 0.829). CONCLUSION: The increase in TLR4 expression has good sensitivity but low specificity. TLR4 expression, in combination with CRP, could become a reliable biomarker for the diagnosis of LONS.

scholarly journals Emphysematous Cystitis Occurred in the Case Treated with Steroid for Autoimmune Hepatitis

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Tateki Yoshino ◽  
Shinya Ohara ◽  
Hiroyuki Moriyama
Keyword(s):  
Blood Culture ◽  
Autoimmune Hepatitis ◽  
Complete Blood Count ◽  
Bladder Wall ◽  
Foley Catheter ◽  
C Reactive Protein ◽  
Laboratory Examination ◽  
Emphysematous Cystitis ◽  
Reactive Protein ◽  
Wbc Count

Emphysematous cystitis is a rare clinically entity, more commonly seen in diabetic, immunocompromised patients, which was characterized by air within the bladder wall and lumen. A 83-year-old woman was introduced to our department with fever elevation and abnormal findings of computed tomography (CT). She took orally prednisolone for autoimmune hepatitis. Pelvic CT revealed diffuse air throughout the bladder wall. Urinalysis showed combined hematuria and pyuria.Escherichia coliwas detected in blood culture. Abnormal findings of complete blood count and laboratory examination included an elevated WBC count (12,200/L), C-reactive protein (11.7 mg/dL), and creatinine (1.07 mg/dL). Cystoscopy confirmed diffuse submucosal emphysema throughout. On the basis of diagnosis with emphysematous cystitis, she was treated with antibiotics based on the results of blood culture and indwelling Foley catheter. After treatment, the improvement of inflammatory findings and submucosal emphysema on cystoscopy and CT were achieved.

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

Comparison of procalcitonin and c-reactive protein with blood culture in early diagnosis of neonatal sepsis

2019 ◽  
Vol 12 (3) ◽  
pp. 49-54
Author(s):  
Swati Karad ◽  
◽  
Desma D'Souza ◽  
Sujata Baveja ◽  
◽  
...  
Keyword(s):  
Blood Culture ◽  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Diagnostic Significance of White Blood Cell Count and C-Reactive Protein in Neonatal Sepsis; Asella Referral Hospital, South East Ethiopia

2018 ◽  
Vol 12 (1) ◽  
pp. 209-217
Author(s):  
Abebe Sorsa
Keyword(s):  
Blood Culture ◽  
Blood Cell ◽  
White Blood Cell ◽  
Neonatal Sepsis ◽  
C Reactive Protein ◽  
Diagnostic Significance ◽  
Gram Negative ◽  
Reactive Protein ◽  
Wbc Count ◽  
Sensitivity Specificity

Introduction:Nowadays various biochemical markers, such as C-Reactive Protein (CRP), Procalcitonin and tumor necrosis factor alpha, have been proposed as a potential marker for screening neonatal sepsis. In the current study, we tried to see the diagnostic significance of White Blood Cell (WBC) count and CRP in diagnostic screening of neonatal sepsis.Methods:A prospective cross-sectional study was conducted from May 2016 to April 2017 in Asella Teaching and Referral Hospital. Data were entered into EPI-INFO version 3.5.1 for cleanup and then exported to SPSS version 17 for further analysis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were used to assess the accuracy of CRP and WBC count taking blood culture as gold standard.Results:Data of 303 neonates with clinical sepsis were analyzed. Positive CRP and abnormal WBC were reported in 136(45%) and 99(32.7%) of study subjects respectively. Blood culture turned to be positive in 88(29.4%) of study subjects. The Sensitivity, Specificity, PPV and NPV of WBC count were 59.5 %, 79.6%, 52%, 64.5% respectively while the sensitivity, specificity, PPV and NPV of CRP were 65.6%, 78%, 42% and 91% respectively. By combining both WBC and CRP, the sensitivity, specificity, PPV and NPV improve to 78.5%, 83%, 60% and 93% respectively. CRP positivity rate was comparable across gram positive and gram negative bacteria while high WBC count were more reported among gram positive sepsis than gram negative ( OR 4.8, (95% CI 1.45-15.87, P 0.01)Conclusion:Based on this study’s finding, it can be concluded that CRP alone or in combination with WBC count showed better diagnostic accuracy in neonatal sepsis.

scholarly journals Diagnostic Accuracy of C-Reactive Protein in Neonatal Sepsis

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Sidra Younis ◽  
Muhammad Ali Sheikh ◽  
Amjad Ali Raza
Keyword(s):  
Blood Culture ◽  
Diagnostic Accuracy ◽  
Neonatal Sepsis ◽  
High Sensitivity ◽  
Operational Definition ◽  
C Reactive Protein ◽  
Capillary Refill ◽  
Neonatal Deaths ◽  
Reactive Protein ◽  
Sensitivity Specificity

Sepsis is the most common cause of neonatal mortality and is responsible for 30-50% of total neonatal deaths each year in developing countries. The objective of the study was to determine the diagnostic accuracy of Creactive protein (CRP) in neonatal sepsis. Fifty nine consecutive patients with risk factors and clinical features suggestive of CRP sepsis were selected as per operational definition and fulfilling the inclusion and exclusion criteria. Detailed physical examination was carried out. Blood sample for culture and CRP was taken from all the patients. Results of blood culture and CRP were noted down in the performa. Statistical analysis was performed by SPSS software version 16. Among selected patients 31/59 (52.5%) were male whereas 28/59 (47.5%) were female. Mean age of all patients was 15.47+7.26 days and mean weight was 2.94+0.63Kg. Temperature instability was present in 79.7%, Tachypnea in 69.5%, Tachycardia in 66.1%, delayed capillary refill in 64.4% and oliguria in 55.9%. Blood cultures were positive in 64.4% and raised CRP was found in 64.5%. Sensitivity, specificity, positive predictive value and negative predictive of raised CRP was found to be 97.3%, 95.2%, 97.3% and 95.2% respectively. In conclusion this study show that C-reactive protein has high sensitivity and specificity for establishing the diagnosis of neonatal sepsis which is comparable to that of blood culture results.

scholarly journals Early Onset Neonatal Sepsis; Diagnostic Value of Some Laboratory Tests

2018 ◽  
Vol 4 (1) ◽  
pp. 1109-1114
Author(s):  
Tania Licona ◽  
German Fajardo ◽  
Rubén Ferrera ◽  
Alejandra Mazariegos
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Laboratory Tests ◽  
Calculated Data ◽  
Clinical Situation ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Control Study

Early Onset Neonatal Sepsis (EONS) is a clinical situation resulting from the invasion and proliferation of bacteria, fungi or viruses in the newborn (NB) bloodstream, which occurs within the first 72 hours of life. To determine the diagnostic usefulness of laboratory tests performed on infants with suspicion of early neonatal sepsis at the Santa Barbara Integrated Hospital, Honduras. A case-control study was carried out during 2016; the cases were 20 infants with early onset neonatal sepsis, and the controls were 40 infants who were admitted as potentially septic, but the blood culture result was negative. Sensitivity, specificity, positive predictive value (PPV) and negative (NPV) of leukocytosis, platelets, initial C-reactive protein (CRP) and control were calculated. Data were analyzed with SPSS version 19. It was found that 17 (28.3 %) NB were women and 43 (71.7 %) were men. The VPP of the initial PCR was 5 %, increasing to 85 % in the control study. The isolated microorganism was enterobacter in 6 (30 %) of the RNs. Of the 23 (38.3 %) neonates who presented complications; 11 (48 %) had positive blood culture and 12 (52 %) had negative blood cultures. The discharge condition was medical discharge in 55 (92 %) and referred to a more complex hospital 5 (8 %) of the neonates. The VPP of the C-reactive protein increases considerably when doing a laboratory control,between 24-48 hours.

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 <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.

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