Diagnostic audit of C-reactive protein in neonatal infection
- 1 March 1987
- journal article
- research article
- Published by Springer Nature in European Journal of Pediatrics
- Vol. 146 (2), 147-151
- https://doi.org/10.1007/bf02343221
Abstract
A prospective study of 250 consecutive neonatal admissions to a regional perinatal referral centre and of 10 additional consecutive cases with culture-proven neonatal septicaemia was undertaken. Quantitative C-reactive protein (CRP) determination, white cell count and differential were performed on blood samples obtained from all babies on admission, as well as 10–14 h and 22–26 h later. Using clinical signs, chest X-rays, blood cultures, tracheal aspirates obtained within 4 h of delivery and an abnormal immature/total neutrophil ratio (I/T), infected babies were defined as belonging to one of the following groups: (1) Culture-proven septicaemia (n=19); (2) Clinical septicaemia (n=35); (3) Congenital pneumonia (n=28). The sensitivity, specificity, positive and negative predictive value of CRP were calculated for each sampling time and patient group. No baby had a rise in CRP (>6mg/l) before an abnormal I/T ratio was first detected. A delayed rise in CRP concentration in the majority of infected babies occurred approximately 12–24 h after the abnormal I/T ratio was first detected. The overall specificity of a CRP level of ≥10 mg/l remained approximately constant (97%–94%) while sensitivity increased from 22%–61% with increasing time after admission. The same pattern emerged if each patient group was considered separately. The positive predictive value for a CRP level of ≥10mg/l 22–26 h after admission was 83% and the negative predictive value 82%. CRP had no value in the early diagnosis of neonatal infection. Its main role lies rather in the exclusion or confirmation of infection 24 h after the first clinical suspicion.This publication has 28 references indexed in Scilit:
- C-REACTIVE PROTEIN (CRP) IN EARLY DIAGNOSIS OF NEONATAL SEPTICEMIAActa Paediatrica, 2008
- Evolution of serum prealbumin, C-reactive protein, and orosomucoid in neonates with bacterial infectionThe Journal of Pediatrics, 1984
- Acute-phase proteins in neonatal infectionThe Journal of Pediatrics, 1984
- SEQUENTIAL DETERMINATION OF CRP, α1‐ANTITRYPSIN AND HAPTOGLOBIN IN NEONATAL SEPTICAEMIAActa Paediatrica, 1983
- Serum C-reactive protein and problems of newborn infantsThe Journal of Pediatrics, 1982
- Normal values for mature and immature neutrophils in very preterm babies.Archives of Disease in Childhood, 1982
- Decreased use of antibiotics using a neonatal sepsis screening techniqueThe Journal of Pediatrics, 1981
- Akute Phase - Proteine bei Früh- und NeugeborenenKlinische Padiatrie, 1980
- THE PROTECTIVE EFFECT OF ACUTE PHASE REACTANTS IN NEONATAL SEPSISActa Paediatrica, 1979
- The neonatal blood count in health and disease.I. Reference values for neutrophilic cellsThe Journal of Pediatrics, 1979