Early detection of an early onset infection in the neonate based on measurements of procalcitonin and C-reactive protein concentrations in cord blood

Kordek, Agnieszka; Hałasa, Maciej; Podraza, Wojciech

doi:10.1515/cclm.2008.214

Cited by 32 publications

(25 citation statements)

References 24 publications

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“…Despite the development of rapid quantitative bedside assays for CRP requiring an insignificant amount of blood, the short report by Makhoul and coworkers on late-onset sepsis is the only one published about their use in the neonatal period (11). Some authors studied the usefulness of CRP determinations in neonatal sepsis, but they did not use bedside tests (4,8,17,18). Others studied bedside tests in pediatric patients, but not in neonates (19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

“…It affects 15%-30% of newborn infants admitted to the neonatal intensive care unit, particularly very low birth weight infants, with high mortality (2). Because the suspicion of sepsis in the neonate is often based on non-specific clinical signs, several predictive laboratory parameters have been investigated, including white blood cell count, tumor necrosis factor, interleukin-6, serum amyloid A, procalcitonin and C-reactive protein (CRP) (4)(5)(6)(7)(8). Serial CRP measurements are also used to monitor the evolution of bacterial diseases because CRP concentration drops quickly in response to effective treatment (9).…”

Section: Introductionmentioning

confidence: 99%

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Reliability of two different bedside assays for C-reactive protein in newborn infants

Zecca

Barone

Corsello

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: Bedside tests for C-reactive protein (CRP) have been studied in pediatric patients, but not in neonates. Methods:This study compared the results of two rapid bedside tests for CRP (Quick-Read CRP, Orion Diagnostic, Espoo, Finland and NycoCard CRP-Single Test, Axis-Shield, Oslo, Norway) with those of our central laboratory method (CRP-Lab) in newborn infants. CRP concentrations were determined using 72 samples obtained from 43 infants with suspected sepsis occurring between 1 and 28 days of life. Results: Considering positive CRP concentrations to be G10 mg/L, both bedside tests had good specificity (Quick-Read 80.5%, NycoCard 83.3%) and sensitivity (Quick-Read 97.2%, NycoCard 94.4%) when compared with our CRP-Lab. The agreement of measurement with central laboratory values was high for both the bedside tests, without statistically significant differences between the methods. The Quick-Read and NycoCard methods did not show any statistically significant systematic proportional bias when compared with the central laboratory values. The accuracy of the results of both bedside tests is somewhat decreased when CRP concentrations are )100 mg/L. Conclusions: This study shows that both the QuickRead and the NycoCard test can be used for serial determinations of CRP concentrations in newborn infants. They require small volumes of blood and provide reliable results in -5 min.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reliability of two different bedside assays for C-reactive protein in newborn infants

Zecca

Barone

Corsello

et al. 2009

Clinical Chemistry and Laboratory Medicine

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“…For a single CRP determination at the time of initial evaluation as well as for determinations from cord blood, the CRP diagnostic accuracy varies widely within an unacceptable range of sensitivity [22,23,25,26,27,28,29,30,31,32]. This may be related to the arbitrary choice of optimal cutoff points [27,28,30,33] as well as the insensitive analytic methods with various limits of quantification used in the past [34] to detect the CRP pattern in the earliest course of infection, in particular in the very early neonatal period.…”

Section: Crp In Neonatal Sepsismentioning

confidence: 99%

An Update on the Use of C-Reactive Protein in Early-Onset Neonatal Sepsis: Current Insights and New Tasks

et al. 2012

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C-reactive protein (CRP) is one of the most studied and most used laboratory tests for neonatal sepsis. As part of the acute-phase reaction to infection, it plays a central role in the humoral response to bacterial invasion. The delayed synthesis during the inflammatory response accounts for its low sensitivity during the early phases of the disease. Diagnostic accuracy clearly improves by the performance of serial determinations and by the combination with earlier markers such as interleukins or procalcitonin. CRP is as well particularly useful for monitoring the response to treatment and guiding antibiotic therapy, though nothing replaces the clinical impression and the gold standard (i.e. culture results). In spite of the large amount of research done on CRP in neonates, some topics are still not fully understood, such as the influence of noninfectious factors on CRP levels in healthy as well as in symptomatic neonates and the role of gestational age and birthweight on CRP kinetics. In this review, we aim to give an update on the current evidence on the use of CRP in neonates.

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“…Even with low cut-off values being used [1 to 5 mg/l) sensitivities and specificities ranged from 22 to 74% and from 78 to 97%, respectively. [30][31][32][33] Thus, a single normal value at the initial sepsis work-up is not sufficient to rule out an infection [11].…”

Section: Crp Is Part Of the Acute-phase-responsementioning

confidence: 99%

The Role of C-Reactive Protein in the Diagnosis of Neonatal Sepsis

Hofer¹,

Müller²,

Resch³

2013

Neonatal Bacterial Infection

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Early detection of an early onset infection in the neonate based on measurements of procalcitonin and C-reactive protein concentrations in cord blood

Abstract: The diagnostic model based on seven clinical and laboratory parameters, using the concentration of PCT and CRP measurements in the cord blood, could be a useful tool for the prediction of early onset neonatal infection.

Cited by 32 publications

References 24 publications

Reliability of two different bedside assays for C-reactive protein in newborn infants

Reliability of two different bedside assays for C-reactive protein in newborn infants

An Update on the Use of C-Reactive Protein in Early-Onset Neonatal Sepsis: Current Insights and New Tasks

The Role of C-Reactive Protein in the Diagnosis of Neonatal Sepsis

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