C‐Reactive Protein: An Early Marker for Neonatal Bacterial Infection Due to Prolonged Rupture of Amniotic Membranes And/Or Amnionitis

Salzer, H; Genger, H; Muhar, U; Lischka, A; Schatten, Christian; Pollak, Arnold

doi:10.3109/00016348709103655

Cited by 20 publications

(6 citation statements)

References 5 publications

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“…from these risk factors, it is thought that measuring C-reactive protein (CRP) and/or white blood cells (leukocytes) might be of value for early detection of neonatal infection in these patients. 5,6 In the literature, conflicting results on the use of CRP in the prediction of infection in women with PROM have been reported. [5][6][7] In 2007, Trochez-Martinez et al performed a systematic review and found no clear evidence that supported the use of CRP for the early diagnosis of chorioamnionitis.…”

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confidence: 99%

Is It Useful to Measure C-Reactive Protein and Leukocytes in Patients with Prelabor Rupture of Membranes?

Heyden

Teeffelen

Coolen³

et al. 2010

Amer J Perinatol

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Neonatal infection is the main complication of prelabor rupture of membranes (PROM). We studied the accuracy of measuring C-reactive protein (CRP) and leukocytes in maternal serum to predict neonatal infection. We performed a retrospective cohort study in two hospitals in the Netherlands between 2003 and 2006. We included consecutive women hospitalized for PROM. In both hospitals, CRP and leukocytes were measured routinely in maternal serum every 2 days until delivery. End points considered were clinical neonatal infection and proven neonatal sepsis. The accuracy of CRP and leukocytes was assessed using receiver operating characteristic (ROC) analysis. We included 299 women with PROM, 12 of whom had a twin pregnancy. Gestational age at inclusion varied between 26 weeks and 0 days and 41 weeks and 5 days with a median of 37 weeks and 3 days. In 47 women (16%), the neonate developed a clinical infection. The areas under the ROC curve of CRP and leukocytes in the prediction of clinical neonatal infection were 0.61 and 0.62, respectively. Of the 47 infected neonates, six neonates (2%) had a proven neonatal sepsis. In the mothers of these septic neonates, maternal CRP did not rise above 50 mg/L and leukocyte values varied between 9.8 and 25.8 x 10 (9)/L. In women with PROM, CRP and leukocytes should not be measured routinely.

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confidence: 99%

Is It Useful to Measure C-Reactive Protein and Leukocytes in Patients with Prelabor Rupture of Membranes?

Heyden

Teeffelen

Coolen³

et al. 2010

Amer J Perinatol

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“…The "low values protocol" (calibration range: 0.003-0.050 g/L) permits the measurement of moderately increased CRP concentrations and, at the same time, a great part of normal concentrations in sera from healthy adults (7,16). It can be useful to monitor declining or latent inflammatory reaction (27)(28)(29) or to detect, at the earliest possible moment, an infection in neonate children (30,31) by using a small volume of serum (great sample dilution). Because of the sensitivity of the method, it may be also possible to consider the application of a modified protocol using a lower sample dilution, suitable for other biological fluids with low CRP concentrations, such as synovial fluid (32) in rheumatic disorders, cerebrospinal fluid (CSF) in bacterial and viral meningitis (33)(34), or cord blood serum (17).…”

Section: Discussionmentioning

confidence: 99%

Microparticle‐enhanced nephelometric immunoassay for human C‐reactive protein

Montagne¹,

Laroche²,

Cuilliere³

et al. 1992

Clinical Laboratory Analysis

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Polyfunctional hydrophilic microspheres of 125-nm diameter can be produced by copolymerization of acrylic monomers. Purified c-reactive protein (CRP) was covalently bound to these new micropheres, and the conjugate obtained was used as reagent in a microparticle-enhanced nephelometric immunoassay for human CRP. This assay was based on the measure, with a specially designed nephelometer, of the light scattered by aggregates formed during the immunoagglutination of the conjugate with anti-CRP antiserum. Sensitive inhibition of this agglutination by free CRP (6 ng/ml) allowed CRP quantitation in highly diluted serum samples (1/500-1/2,000), excluding any interference or sample pretreatment. The CRP assay was easy to perform (no washing or phase separation), reliable (coefficients of variation ranged from 1.3% to 9.3% for within-run and between-run determinations), and accurate (mean percentage of recovery: 104%; correlation coefficients with accepted analytical methods greater than or equal to 0.97) over a large range of concentrations. The inhibition mode excluded errors in the antigen excess zone and provided total security at high concentrations.

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“…Neste estudo, utilizamos o teste de aglutinação do látex semiquantitativo por ser de fácil execução. Baseamo-nos no trabalho de Salzer et al 44 , no qual esse método foi utilizado em casuística semelhante à nossa ou, seja, em RNs com fatores de risco para infecção neonatal precoce. …”

Section: Indicadores Imunológicos Nas Infecções Neonataisunclassified

“…Em nossa casuística, todos os RNs tinham pelo menos um fator de risco para infecção e, entre os 18 que se tornaram sintomáticos, 11 deles tinham mais do que um fator de risco associado (tabela 1), fato que nos leva a crer que o estímulo para a produção de proteína C-reativa, através das interleucinas, possa ter ocorrido antes do nascimento. Essa hipótese está de acordo com o estudo de Salzer et al 44 , no qual os autores observaram que de 25 RNs, cujas mães tinham RPM e/ou amnionite clínica, dez apresentaram positividade para proteína C-reativa pelo teste de aglutinação do látex, com seis horas de vida, e todos estes mostraram sintomatologia infecciosa posterior.…”

Section: Proteína C-reativa Ao Nascimentounclassified

Indicadores imunológicos (IgM e proteína C-reativa) nas infecções neonatais

Vaz¹,

Ceccon²,

Diniz³

et al. 1998

Rev. Assoc. Med. Bras.

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RESUMO -A sepse, no período neonatal, está associada com a presença de fatores de risco para infecção e com o estado imunológico do recém-nascido.OBJETIVO. Verificar, em recém-nascidos com fatores de risco para infecção, o papel da proteína C reativa (PCR) 1 em 1991, é de uma resposta sistêmica à infecção manifestada pelo menos por duas das seguintes condições: hipotermia, hipertermia, taquipnéia e taquicardia, e, laboratorialmente, por alterações na contagem de leucócitos no sangue, dispensando a positividade da hemocultura.O quadro laboratorial de sepse, no período neonatal, permanece muito difícil, e o isolamento de um microorganismo no sangue, no líquor (LCR), na urina ou em qualquer outro local fechado constitui o exame mais específico para o diagnóstico de infecção, embora com alguns inconvenientes, o principal deles sendo o período de incubação da cultura de até 72 horas. Com esse período de incubação, 98% das culturas positivas serão identificadas, com exceção de alguns Staphylococcus coagulase negativos, anaeróbios e fungos 2 . Squire et al.3 , em 1979, mostraram que somente 82% dos RNs com infecção sistêmica comprovada por culturas post-mortem e achados de necropsia tinham culturas positivas in vivo. Visser e Hall 4 relataram que 15% dos RNs com diagnóstico de meningite e com cultura de líquor positiva tinham hemocultura negativa. Portanto, a negatividade da hemocultura não exclui infecção sistêmica.A cultura de urina deve sempre ser colhida de punção suprapúbica para evitar contaminação. É uma técnica relativamente difícil e o crescimento bacteriano demora o mesmo tempo que as outras culturas como a do LCR 5 . Os métodos para detectar a presença de antí-

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C‐Reactive Protein: An Early Marker for Neonatal Bacterial Infection Due to Prolonged Rupture of Amniotic Membranes And/Or Amnionitis

Cited by 20 publications

References 5 publications

Is It Useful to Measure C-Reactive Protein and Leukocytes in Patients with Prelabor Rupture of Membranes?

Is It Useful to Measure C-Reactive Protein and Leukocytes in Patients with Prelabor Rupture of Membranes?

Microparticle‐enhanced nephelometric immunoassay for human C‐reactive protein

Indicadores imunológicos (IgM e proteína C-reativa) nas infecções neonatais

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