C-Reactive Protein and other Hematological parameters for diagnosis of Neonatal Sepsis
Keywords:
Neonatal sepsis, C-reactive protein, Sepsis screen
Abstract
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. The present study was therefore carried out to determine the usefulness of C-reactive protein (CRP) for evaluation of neonatal sepsis in teaching hospital of central India.
Method: 82 neonates with clinical suspicion of sepsis were prospectively studied over a 12 month period. 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 82 neonates studied, 67 (81.7%) had positive CRP while 58 (70.73%) had positive blood culture. The sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of CRP were 81.7%, 88.0%, 95.7%, 59.5% and 83.2%. respectively.
Conclusion: The qualitative method of estimating CRP which is cheap and rapid has moderate sensitivity, specificity and negative predictive value. It is a good diagnostic test and can identify the infection in neonates at the time of initial assessment.
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References
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35. Khashabi J, Karamiyar M, Taghinejihad H, Shirazi M: Use of Serial C-Reactive Protein Measurements for Determination of the Length of Empiric Antibiotic Therapy in Suspected Neonatal Sepsis. Iran J Med Sci. 2004;29:31–5.
36. Ghosh S, Mittal M, Jaganathan G. Early diagnosis of neonatal sepsis using a hematological scoring system. Indian J Med Sci. 2001Sep;55(9):495–500.
37. Makkar M, Gupta C, Pathak R, Garg S, Mahajan NC. Performance Evaluation of Hematologic Scoring System in Early Diagnosis of Neonatal Sepsis. J Clin Neonatol. 2013 Jan-Mar; 2(1): 25–29.
38. Narasimha A, Harendra Kumar ML. Significance of Hematological Scoring System (HSS) in early diagnosis of neonatal sepsis. Indian J Hematol Blood Transfus. 2011Mar;27(1):14–7. [PubMed]
39. Basu S, Guruprasad, Narang A, Garewal G. Diagnosis of sepsis in the high risk neonate using a hematologic scoring system. Indian J Hematol Blood Transf. 1999;17:32–34.
40. Rodwell RL, Leslie AL, Tudehope DI. Early diagnosis of neonatal sepsis using a hematologic scoring system. J Pediatr. 1988 May;112(5):761–7.
2. Omene JA: Neonatal Septicaemia in Benin city, Nigeria: A Review of 74 cases. Trop Geogr Med. 1979; 31:35–39. [PubMed]
3. Bacterial etiology of serious infections in young infants in developing countries: results of a multicenter study. The WHO Young Infants Study Group. Pediatr Infect Dis J 1999, 18(10 Suppl.):S17–22. [PubMed]
4. Hammerschlag MR, Klein JO, Herschel M, Chen FC, Fermin R: Patterns of use of antibiotics in two newborn nurseries N Engl J Med. 1977; 296:1268-9. [PubMed]
5. Philip AG, Hewitt JR: Early diagnosis of neonatal sepsis. Pediatrics 1980, 65:1036-41. [PubMed]
6. Gerdes JS, Polin RA: Sepsis screen in neonates with evaluation of plasma fibronectin. Pediatr Infect Dis J. 1987; 6:443-6. [PubMed]
7. Murray BE. Can antibiotic resistance be controlled? The New England Journal of Medicine. 1994;330(17):1229-30. [PubMed]
8. Buttery JP: Blood cultures in newborns and children: optimising an everyday test. Arch Dis Child Fetal Neonatal Ed. 2002; 87:25–8. [PubMed]
9. Ehl S Gering B, Bartmann P, Högel J, Pohlandt F. C-re¬active protein is a useful marker for guiding duration of antibiotic therapy in suspected neonatal bacterial infection. Pediatrics. 1997; 99:216–21.
10. Tillett WS, Francis T. Serological Reactions in Pneumonia with a Non-Protein Somatic Fraction of Pneumococcus. The Journal of Experimental Medicine. 1930;52(4):561-71. [PubMed]
11. Ehl S Gering B, Bartmann P, Högel J, Pohlandt F. C-re¬active protein is a useful marker for guiding duration of antibiotic therapy in suspected neonatal bacterial infection. Pediatrics.1997;99:216–21. [PubMed]
12. Clyne B, Olshaker JS. The C-reactive protein. J Emerg Med.1999;17:1019-25. [PubMed]
13. Marshal SE. Immunological factors in diseases. In : Boon NA, Cooledge NR, Walker BR, et al. editors . Davidson ’s principles and practice of medicine. 20thed . Churchill Livingstone ; 2006. p. 63-91.
14. Khashabi J, Karamiyar M, Taghinejihad H, Shirazi M: Use of Serial C-Reactive Protein Measurements for Determination of the Length of Empiric Antibiotic Therapy in Suspected Neonatal Sepsis. Iran J Med Sci.2004;29:31–35.
15. Kaapa P, Koistinen E. Maternal and neonatal C-reactive protein after interventions during delivery. Acta Obstetricia Et Gynecologica Scandinavica. 1993;72(7):543-6. [PubMed]
16. Pepys MB, Hirschfield GM. C-reactive protein: a critical update. The Journal of Clinical Investigation. 2003;111(12):1805-12.[PubMed]
17. Clyne B, Olshaker JS: The C-Reactive Protein. J Emerg Med. 1999;17:1019–25. [PubMed]
18. Mustafa S, Farooqui S, Waheed S, Mahmook K: Evaluation of c-reactive protein as early indicator of blood culture positivity in neonates. Pak J Med Sci. 2005; 21:69–73.
19. Benitz WE, Han MY, Madan A, Ramachandra P. Serial serum C-reactive protein levels in the diagnosis of neonatal infection. Pediatrics. 1998;102(4):E41-E. [PubMed]
20. Berger C, Uehlinger J, Ghelfi D, Blau N, Fanconi S. Comparison of C-reactive protein and white blood cell count with differential in neonates at risk for septicaemia. European Journal of Pediatrics. 1995;154(2):138-44. [PubMed]
21. Hofer N, Müller W, Resch B. Non-infectious conditions and gestational age influence Creactive protein values in newborns during the first 3 days of life. Clinical Chemistry and Laboratory Medicine: CCLM / FESCC. 2011;49(2):297-302.
22. Mathai E, Christopher U, Mathai M, Jana AK, Rose D, Bergstrom S. Is C-reactive protein level useful in differentiating infected from uninfected neonates among those at risk of infection? Indian Pediatrics. 2004;41(9):895-900. [PubMed]
23. Chako B, Sohi I: Early Onset Neonatal Septicaemia. Indian J Pediatr. 2005 Jan;72(1):23–6. [PubMed]
24. Roy I, Jain A, Kumar M, Agarwal SK: Bacteriology of Neonatal Septicaemia in a Tertiary Hospital of Northern India. Indian J Med Microbiol. 2002 July-Sep; 20(3):156–9. [PubMed]
25. Ahmed Z, Ghafoor T, Waqar T, Ali S, Aziz S, Mahmud S. Diagnostic Value of C-Reactive Protein and Haematologic Parameters in Neonatal Sepsis. J Coll Physicians Surg Pak. 2005 Mar, 15(3):152–6. [PubMed]
26. Manucha V, Rusia U, Sikka M, Faridi MMA, Madan N: Utility of Haematological Parameters and C-Reactive Protein in the Detection of Neonatal Sepsis. J Paediatr Child Health. 2002 Oct; 38(5):459–64. [PubMed]
27. Ugochukwu EF: Bacterial Isolates in Neonatal Infections. Nig Med Pract. 2003; 44:56–8.
28. Boma A West , Oliemen Peterside . Sensitivity pattern among bacterial isolates in neonatal septicaemia in port Harcourt. Ann Clin Microbiol Antimicrob. 2012 Mar; 11: 7. [PubMed]
29. Roy I, Jain A, Kumar M, Agarwal SK. Bacteriology of Neonatal Septicaemia in a Tertiary Hospital of Northern India. Indian J Med Microbiol. 2002 Jul-Sep;20(3):156–9. [PubMed]
30. Ahmed Z, Ghafoor T, Waqar T, Ali S, Aziz S, Mahmud S. Diagnostic value of c-reactive protein and haematologic parameters in neonatal sepsis. J Coll Physicians Surg Pak. 2005 Mar;15(3):152–6. [PubMed]
31. Manucha V, Rusia U, Sikka M, Faridi MMA, Madan N. Utility of haematological parameters and c-reactive protein in the detection of neonatal sepsis. J Paediatr Child Health. 2002;38:459–464. [PubMed]
32. Edwards MS. In: Neonatal Perinatal Medicine: Diseases of the fetus and infant. 7. Fanaroff AA, Martin RJ, editor. St Louis: CV Mosby; 2002. Postnatal Bacterial Infections; pp. 706–726.
33. Benitz WE, Han MY, Madan A, Ramachandra P. Serial serum C-reactive protein levels in the diagnosis of neo¬natal infection. Pediatrics. 1998 Oct;102(4):E41. [PubMed]
34. Jan AZ, Zahid SB, Ahmad S. Role of C-reactive protein in diagnosing neonatal sepsis. Khyber Med Univ J. 2012; 4(4): 161-4.
35. Khashabi J, Karamiyar M, Taghinejihad H, Shirazi M: Use of Serial C-Reactive Protein Measurements for Determination of the Length of Empiric Antibiotic Therapy in Suspected Neonatal Sepsis. Iran J Med Sci. 2004;29:31–5.
36. Ghosh S, Mittal M, Jaganathan G. Early diagnosis of neonatal sepsis using a hematological scoring system. Indian J Med Sci. 2001Sep;55(9):495–500.
37. Makkar M, Gupta C, Pathak R, Garg S, Mahajan NC. Performance Evaluation of Hematologic Scoring System in Early Diagnosis of Neonatal Sepsis. J Clin Neonatol. 2013 Jan-Mar; 2(1): 25–29.
38. Narasimha A, Harendra Kumar ML. Significance of Hematological Scoring System (HSS) in early diagnosis of neonatal sepsis. Indian J Hematol Blood Transfus. 2011Mar;27(1):14–7. [PubMed]
39. Basu S, Guruprasad, Narang A, Garewal G. Diagnosis of sepsis in the high risk neonate using a hematologic scoring system. Indian J Hematol Blood Transf. 1999;17:32–34.
40. Rodwell RL, Leslie AL, Tudehope DI. Early diagnosis of neonatal sepsis using a hematologic scoring system. J Pediatr. 1988 May;112(5):761–7.
CITATION
DOI: 10.17511/ijmrr.2014.i04.09
Published: 2014-08-31
How to Cite
1.
Patel U, Kumar Patel V, Prasad Patel N, Verma J, Kumar Ratre B, Verma S. C-Reactive Protein and other Hematological parameters for diagnosis of Neonatal Sepsis. Int J Med Res Rev [Internet]. 2014Aug.31 [cited 2024Apr.20];2(4):311-8. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/112
Section
Original Article
OAI - Open Archives Initiative
