Assessing the Diagnostic Accuracy of C-Reactive Protein (CRP) in Neonatal Sepsis Detection
Main Article Content
Keywords
C-reactive protein, Neonates, Neonatal Sepsis.
Abstract
The purpose of this study was to evaluate how well C-reactive protein (CRP) levels diagnose newborn sepsis.
Methods: At the KRL General Hospital's Neonatology unit, a validation study was carried out over the course of seven months, from February to August 2012. Using purposive sampling, a sample size of 147 neonates was established based on a 95% confidence level, 50% predicted prevalence, 75% sensitivity, 95% specificity, and 10% desired accuracy.
Results: The neonates' mean age was 5.72 days ± 3.86. Of the patients, 81 (55.1%) were male and 66 (44.9%) were female. Through blood culture, 43 neonates (29.25%) had neonatal sepsis confirmed, whereas 104 neonates (70.75%) did not test positive for the condition. When it came to identifying acute neonatal sepsis, CRP's sensitivity and specificity were 76.92% and 53.49%, respectively. 48.94% was the negative predictive value and 80% was the positive predictive value. In terms of identifying neonatal sepsis, CRP had an overall diagnosis accuracy of 70.07%.
Conclusion: Although it lacks specificity, CRP estimation can be helpful in identifying newborn sepsis; nevertheless, it should not be the only method used.
References
2. Mahmood A, Karamat KA, Butt T. Neonatal Sepsis: High antibiotic resistance of the bacterial pathogens in a Neonatal Intensive Care Unit in Karachi. J Pak Med Assoc. 2002;52(8):348-50
3. Shirazi H, Riaz S, Tahir R. Role of the Hematological Profile in Early Diagnosis of Neonatal Sepsis. Ann Pak Inst Med Sci. 2010; 6:152-156.
4. Tappero E, Johnson P. Laboratory evaluation of neonatal sepsis. Newborn InfantNurs Rev. 2010;10 (4):209-217. doi: 10.1053/j.nainr.2010.09.010
5. Sakha K, Husseini MB, Seyyedsadri N. The role of the procalcitonin in diagnosis of neonatal sepsis and corelation between procalcitonin and C-reactive protein in these patients. Pak J Biol Sci. 2008;11(14):1785–1790.
6. Ahmed Z, Ghafoor T, Waqar T, Ali S, Aziz S, Mahmud S. Diagnostic value of C-reactive protein and haematological parameters in neonatal sepsis. J Coll Physicians Surg Pak. 2005;15(3):152-156.
7. Selimovic A, Skokic F, Bazardzanovic M, Selimovic Z. The predictive score for early-onset neonatal sepsis. Turk J Pediatr. 2010; 52:139-144.
8. Celik IH, Demirel FG, Uras N, Oguz SS, Erdeve O, Biyikli Z, et al. What are the cut-off levels for IL-6 and CRP in neonatal sepsis? J Clin Lab Anal. 2010; 24:407–412. doi: 10.1002/jcla.20420.
9. Kawamura M, Nishida H. The usefulness of serial C-reactive protein measurement in managing neonatal infection. Acta paediatrica. 1995;84(1): 10-3.doi: 10.1111/j.1651-2227. 1995.tb13475.x
10. Mair RJ, Joy AH, Finney H, Weaver A. Creating an algorithm for requesting C-reactive protein in the emergency department. Eur J Emerg Med. 2010;17(2):125-126. doi: 10.1097/MEJ.0b013e3283366ceb
11. Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis. 2004;39(2):206-217.
12. Benitz WE, Han MY, Madan A, Ramachandra P. Serial Serum C-reactive protein levels in diagnosis of neonatal infection. Pediat. 1998; 102:41.
13. Mathers NJ, Pohlandt F. Diagnostic audit of C-reactive Protein in neonatal infection. Eur J Pediatr. 1987;146(2):147-151.
14. Wagle S, Grauang A, Kohan R, Evan Sr. C-reactive protein as a diagnostic tool of sepsis in very immature babies. J. Paediatr Chold Health. 1994;30(1):40-44.
15. Chan Dk, Ho LY. Usefulness of C-reactive Protein in the diagnosis of neonatal sepsis. Singapore Med J. 1997;38(6):252-255.
16. Jave DL, Waites KB. Clinical applications of C-reactive Protien in pediatrics. Pediatr Infect Dis J. 1997;16(6):735–746.
17. Jin Charadze JN, Abelashvili D, McHedlishyili M, Kacharava M. Diagnostic value of C-reactive protein test at early-onset sepsis in preterm infants. Georgian Med News. 2006;(130):87-91.
18. Pepys MB. C reactive Protein. Fifty years on. Lancet. 1981; 1:653-657.
19. Ain E, Cabata EE, Guzman DM. Serum CRP and problems of Newborn infant. J Pediatr. 1982:101:438-440.
20. Stoll BJ , Gordon T, Korones SB, Shankaran S, Tyson JE, Bauer CR, et al. Late onset sepsis in very low birth weight neonates. Report from National Institute of child health and human development Neonatal research Network. J Pediatr. 1996;129(1):63-71.
21. Manucha V, Rusia U, Sikka M, Faridi MM, Madan N. Sepsis. J Paediatr Child Health. 2002;38(5):459-464.
22. Rodwell RL, Leslie AL, Tudehope DI. Early diagnosis of neonatal sepsis using a hematologic scoring system. J Pediatr. 1988;112(5):761-767
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.