scholarly journals Qualitative C-reactive protein as a marker of neonatal sepsis in a tertiary neonatal unit in Sudan

2013 ◽  
Vol 1 (2) ◽  
pp. 21
Author(s):  
Abdelmoneim E. Kheir ◽  
Ghada A. Jobara ◽  
Kamal M. Elhag ◽  
Mohamed Z. Karar
Keyword(s):  
Risk Factors ◽  
Blood Culture ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
University Hospital ◽  
C Reactive Protein ◽  
Chi Square ◽  
Reactive Protein ◽  
Chi Square Test ◽  
A Prospective Study

Sepsis is one of the most common causes of morbidity and mortality in newborns. Diagnosis of neonatal sepsis may be difficult because clinical presentations are often non-specific. The aim of this study was to evaluate the role of qualitative C-reactive protein in the diagnosis of neonatal sepsis, and examine the correlation between C-reactive protein, blood culture and risk factors for sepsis. This was a prospective study, conducted in the Neonatal Intensive Care Unit at Soba University Hospital, Sudan. A total of seventy babies with a clinical diagnosis of sepsis were included. Chi square test was used to determine the association between C-reactive protein and risk factors for sepsis and also the association between C-reactive protein and blood culture. Blood culture was positive in 41.4% of babies, and C-reactive protein was positive in 58% of babies with positive blood culture. There was significant association between C-reactive protein results and blood culture (P=0.00). In conclusion, we can assume that Creactive protein is a reliable diagnostic marker of neonatal sepsis, especially in developing communities with poor resources.

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

Evaluation of Microbiologic and Hematologic Parameters and E-Selectin as Early Predictors for Outcome of Neonatal Sepsis

2009 ◽  
Vol 133 (8) ◽  
pp. 1291-1296 ◽  
Author(s):  
Maysaa El Sayed Zaki ◽  
Hesham El Sayed
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Newborn Infants ◽  
Prognostic Indicator ◽  
Diagnostic Value ◽  
Total Leukocyte Count ◽  
C Reactive Protein ◽  
Gram Negative ◽  
Reactive Protein ◽  
Early Predictors

Abstract Context.—Early diagnosis of neonatal sepsis is mandatory. Various markers are used to diagnose the condition. Objective.—To evaluate the diagnostic value of various clinical data and hematologic parameters, such as total leukocyte count, absolute neutrophil count, immature to total neutrophil ratio, and soluble E-selectin (sE-selectin) in identification and outcome of neonatal sepsis. Design.—Newborn infants with a clinical diagnosis of sepsis in the neonatal intensive care unit at Mansoura University Children's Hospital during the period between July 2007 and December 2007 were eligible for study. In addition, 30 healthy neonates were included in the study. Complete hematologic and microbiologic laboratory investigations were performed, and serum E-selectin was measured. Results.—Plasma sE-selectin levels were significantly higher (P < .001) in infected infants (mean [SD], 156.9 [77.0] ng/mL) than in noninfected (mean [SD], 88.8 [47.1] ng/mL) and healthy infants (mean [SD], 8.67 [3.74] ng/ mL). Infants with gram-negative sepsis had higher sE-selectin levels than did those with gram-positive sepsis (P = .04). C-reactive protein was the best laboratory test for diagnosis of neonatal sepsis, with an overall sensitivity and specificity of 86% and 97%, respectively. Performing sE-selectin with C-reactive protein or immature to total ratio tests increased the specificity, but reduced the sensitivity, of the tests for the determination of neonatal sepsis. Plasma sE-selectin levels were higher in nonsurvivors than in survivors (P = .01) and were higher in those with hemodynamic dysfunction than in those without hemodynamic dysfunction (P < .001). Conclusions.—We conclude that plasma sE-selectin levels are elevated in neonatal sepsis. Significant elevation was associated with gram-negative sepsis. Plasma sE-selectin had low diagnostic value when used alone or in combination with other tests; however, it can be used as a prognostic indicator for the outcome of neonatal 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 Surgical Site Infections (SSI) and factors associated in a private tertiary care teaching hospital in Raichur, Karnataka, India

2018 ◽  
Vol 5 (8) ◽  
pp. 2899
Author(s):  
Prashanta Swami Pujar ◽  
K. B. Phuleker ◽  
Nagaraj Bhalki
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Research Centre ◽  
Chi Square ◽  
College Hospital ◽  
Factors Associated ◽  
Duration Of Surgery ◽  
Chi Square Test ◽  
A Prospective Study

Background: Prevention of Surgical site infection (SSI) remains a focus of attention because wound infections continue to be a major source of expense, morbidity, and even mortality. Three quarters of deaths of surgical patients with SSIs are attributed to nosocomial infections, nearly all of which are organ/space infections. The objective of the present study was to estimate the incidence of SSI and to study the various risk factors associated with SSI.Methods: This is a prospective study of 180 eligible cases eligible subjects, who underwent various surgeries in the department of General Surgery after applying inclusion and exclusion criteria. The study conducted at the Navodaya Medical College Hospital and Research Centre, Raichur. The tenure for the study was April 2017 to June 2017. Data was collected using pretested proforma. Data was analysed using SPSS version 16. Chi -square test and multiple logistic regression was applied to know the association between various risk factors and occurrence of SSI.Results: Among 180 patients 33 (18.33%) developed surgical site infections (SSI). Among 33 SSIs 25 (75.76%) were grade 3 and 8 (24.24%) were grade 4 infections. SSIs were found more commonly among patients over 50 years, diabetics, HIV infected patients, patients with longer duration of surgery and associations with these factors were found statistically significant.Conclusions: The incidence rate of SSI was quite high, and its end results will have a greater impact on patients as well as on healthcare systems. Prevention of SSI requires multipronged approach targeting both patient related and procedure related risk factors in pre- operative, intra-operative, and post-operative period.

scholarly journals ASSESSMENT OF THE ROLE OF CRP AND PLATELET COUNT IN EARLY NEONATAL SEPSIS

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Sachin Walchand Shaha
Keyword(s):  
Platelet Count ◽  
Blood Culture ◽  
Neonatal Intensive Care ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Negative ◽  
Reactive Protein ◽  
Resource Limited ◽  
Group B ◽  
A Prospective Study

Material and Methods: A Prospective study was performed in the department of Pediatrics in territory care institute for the duration of 8 months. Forty newborns were included in the study group to satisfy including criteria. Before antibiotic treatment, neonates CRP and platelet count were assessed. Data were analyzed by SPSS software. Results: Out of the 40 cases, 22 were male babies, and the rest 18 were female. Blood culture was positive in 19 out of the 40 cases, CRP was positive in 21 cases, and thrombocytopenia was observed in 16 cases.  Klebsiella is the commonest gram organism causing sepsis in the Neonatal Intensive Care Unit. The Gram-positive organisms grown are Coagulase Positive and Coagulase-negative Staphylococci, Group B Beta Hemolytic Streptococcus, and Enterococcus. Out of 16 thrombocytopenia neonatal, 15 shows Gram-negative and 1 shows gram-positive blood culture. Conclusion: Qualitative analysis of C-reactive protein can be used as an early marker of sepsis, especially in resource-limited settings. Although thrombocytopenia occurs predominantly in gram-negative sepsis, there is insufficient evidence to support the use of platelet count to differentiate between gram-positive and gram-negative sepsis. Keywords: CRP, Platelet count,blood cultures, sepsis.

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 Procalcitonin is a Better Biomarker than C-Reactive Protein in Newborns Undergoing Cardiac Surgery: The Prokineca Study

2016 ◽  
Vol 11 ◽  
pp. BMI.S40658 ◽  
Author(s):  
Sara Bobillo Pérez ◽  
Javier Rodríguez-Fanjul ◽  
Iolanda Jordan García ◽  
Julio Moreno Hernando ◽  
Martín Iriondo Sanz
Keyword(s):  
Cardiopulmonary Bypass ◽  
Neonatal Intensive Care ◽  
Area Under The Curve ◽  
C Reactive Protein ◽  
Sepsis Diagnosis ◽  
Reactive Protein ◽  
Optimal Area ◽  
A Prospective Study ◽  
Kinetics Of ◽  
Better Than

Objectives To assess the kinetics of procalcitonin (PCT) and C-reactive protein (CRP) in newborns after cardiothoracic surgery (CS), with and without cardiopulmonary bypass, and to assess whether PCT was better than CRP in identifying sepsis in the first 72 hours after CS. Patients and Methods This is a prospective study of newborns admitted to the neonatal intensive care unit after CS. Interventions PCT and CRP were sequentially drawn 2 hours before surgery and at 0, 12, 24, 48, and 72 hours after surgery. Results A total of 65 patients were recruited, of which 14 were excluded because of complications. We compared the kinetics of PCT and CRP after CS in bypass and non-bypass groups without sepsis; there were no differences in the PCT values at any time (24 hours, P = 0.564; 48 hours, P = 0.117; 72 hours, P = 0.076). Thirty-five patients needed bypass, of whom four were septic (11.4%). Significant differences were detected in the PCT values on comparing the septic group to the nonseptic group at 48 hours after cardiopulmonary bypass ( P= 0.018). No differences were detected in the CRP values in these groups. A suitable cutoff for sepsis diagnosis at 48 hours following bypass would be 5 ng/mL, with optimal area under the curve of 0.867 (confidence interval 0.709–0.958), P< 0.0001, and sensitivity and specificity of 87.5% (29.6–99.7) and 72.6% (53.5–86.4), respectively. Conclusions This is a preliminary study but PCT seems to be a good biomarker in newborns after CS. Values over 5 ng/mL at 48 hours after CS should alert physicians to the high risk of sepsis in these patients.

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.

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