C-reactive protein for late-onset sepsis diagnosis in very low birth weight infants

Beltempo, Marc; Viel-Thériault, Isabelle; Thibeault, Roseline; Julien, Anne–Sophie; Piedboeuf, Bruno

doi:10.1186/s12887-018-1002-5

Cited by 34 publications

(30 citation statements)

References 31 publications

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“…As the level of CRP synthesis reflects the intensity of the inflammatory process, it is used as one of the clinical markers of infectious and inflammatory diseases, including sepsis 59,60. It was demonstrated that high concentrations of CRP in the development of sepsis indicate unfavorable prognosis 61. Therefore, rats susceptible to hypoxia are characterized by more pronounced inflammatory reaction in response to the administration of the LPS.…”

Section: Discussionmentioning

confidence: 99%

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<p>Dependence of the severity of the systemic inflammatory response on resistance to hypoxia in male Wistar rats</p>

Джалилова

Косырева

Diatroptov

et al. 2019

JIR

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The aim of the study was to characterize the severity of the systemic inflammatory response induced by lipopolysaccharide (LPS) in animals with different resistance levels to hypoxia. Materials and methods: Two to three months old male Wistar rats (220-240 g) were divided according to hypoxia tolerance in a hypobaric chamber. After a month, they were injected intraperitoneally with Escherichia coli LPS at a dose of 1.5 mg/kg. After 3, 6 and 24 hours of LPS injection, we studied the levels of IL-1β, C-reactive protein (CRP) and TGF-β in the serum, the expression of Hif-1α and Nf-kb in the liver, morphological disorders in the lung and ex vivo production of IL-10 by splenic cells activated by ConA. Results: In the early periods after the injection of LPS, increase in Nf-kb expression in the liver was observed only in the rats susceptible to hypoxia. After 6 hours of LPS injection, the number of neutrophils in the interalveolar septa of the lungs of rats susceptible to hypoxia was higher than in tolerant rats. This points to the development of more pronounced LPS-induced inflammation in the rats susceptible to hypoxia and is accompanied by increased expression of Hif-1α in the liver after 6 hours of LPS administration, serum IL-1β level after 3 hours and CRP level after 24 hours. The production of the anti-inflammatory cytokine IL-10 by the spleen was significantly decreased after 6 hours of LPS injection only in the animals tolerant to hypoxia. After 24 hours of LPS injection, a significant decrease in serum TGF-β level occurred in the rats tolerant to hypoxia in comparison with the control group, which improved the survival rates of the animals. Conclusion: We have demonstrated the differences in the severity of the LPS-induced inflammatory response in male Wistar rats with different resistance levels to hypoxia. Rats susceptible to hypoxia are characterized by a more pronounced inflammatory response induced by LPS.

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Section: Discussionmentioning

confidence: 99%

“… 59 , 60 It was demonstrated that high concentrations of CRP in the development of sepsis indicate unfavorable prognosis. 61 Therefore, rats susceptible to hypoxia are characterized by more pronounced inflammatory reaction in response to the administration of the LPS.…”

Section: Discussionmentioning

confidence: 99%

<p>Dependence of the severity of the systemic inflammatory response on resistance to hypoxia in male Wistar rats</p>

Джалилова

Косырева

Diatroptov

et al. 2019

JIR

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“…Use of the combination of CRP and CBC for discontinuation of antibiotics at 36 h after LOS work-up has previously been suggested by Beltempo et al ( 31 ). CBC abnormalities in this study were abnormal white blood cell count, thrombocytopenia or a high immature neutrophil count.…”

Section: Discussionmentioning

confidence: 98%

Antibiotic Discontinuation 24 h After Neonatal Late-Onset Sepsis Work-Up—A Validated Decision Tree Model

et al. 2021

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Objectives: Neonatal late-onset sepsis work-up is a frequent occurrence in every neonatal department. Blood cultures are the diagnostic gold standard, however, a negative culture prior to 48–72 h is often considered insufficient to exclude sepsis. We aimed to develop a decision tree which would enable exclusion of late-onset sepsis within 24 h using clinical and laboratory variables.Study Design: Infants evaluated for late-onset sepsis during the years 2016–2019, without major malformations, in a tertiary neonatal center were eligible for inclusion. Blood cultures and clinical and laboratory data were extracted at 0 and 24 h after sepsis work-up. Infants with bacteriologically confirmed late-onset sepsis were compared to matched control infants. Univariate logistic regression identified potential risk factors. A decision tree based on Chi-square automatic interaction detection methodology was developed and validated.Results: The study cohort was divided to a development cohort (105 patients) and a validation cohort (60 patients). At 24 h after initial evaluation, the best variables to identify sepsis were C-reactive protein > 0.75 mg/dl, neutrophil-to-lymphocyte ratio > 1.5 and sick-appearance at 24 h. Use of these 3 variables together with blood culture status at 24 h, enabled identification of all infants that eventually developed sepsis through the decision tree model. Our decision tree has an area under the receiver operating characteristic curve of 0.94 (95% CI: 0.90–0.98).Conclusions: In non-sick appearing infants with a negative blood culture at 24 h and normal laboratory values, sepsis is highly unlikely and discontinuing antibiotics after 24 h is a viable option.

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“…As the level of CRP synthesis reflects the intensity of the inflammatory process, it is used as one of the clinical markers of infectious and inflammatory diseases, including sepsis [46, 47]. It was demonstrated that high concentrations of CRP in the development of sepsis indicate unfavorable prognosis [48]. According to the literature, the main inducer of CRP gene expression is IL-6, with IL-1 enhancing the effect during the acute phase of an inflammatory/infectious process [49].…”

Section: Discussionmentioning

confidence: 99%

Morphological Characteristics of the Thymus and Spleen and the Subpopulation Composition of Lymphocytes in Peripheral Blood during Systemic Inflammatory Response in Male Rats with Different Resistance to Hypoxia

Джалилова

Косырева

Diatroptov

et al. 2019

International Journal of Inflammation

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On the model of the systemic inflammatory response (SIRS), induced by lipopolysaccharide (LPS), the morphological and functional changes in the thymus and spleen and the subpopulation composition of peripheral blood lymphocytes of rats differing in resistance to hypoxia were studied. It was demonstrated that the level of endotoxin in blood serum after 3 hours of LPS administration in susceptible-to-hypoxia rats was 64 times higher than in the control group, while in tolerant-to-hypoxia animals it was only 8 times higher in 6 hours. After 24 hours of LPS injection, only in susceptible-to-hypoxia rats did the level of C-reactive protein in blood serum increase. There is a difference in the dynamics of morphological changes of lymphoid organs after LPS injection in tolerant- and susceptible-to-hypoxia animals. After 3 hours of LPS administration, the tolerant-to-hypoxia rats showed no changes in the thymus, spleen, and subpopulation composition of lymphocytes in peripheral blood. After 6 hours there was only a decrease in B-lymphocytes and increase in cytotoxic T-lymphocytes and NK cells. After 1 day of LPS injection, the tolerant-to-hypoxia rats had devastation in PALS of the spleen. After 3 hours of LPS injection the susceptible-to-hypoxia animals had reactive changes in the lymphoid organs: decrease of the thymus cortex, narrowing of the marginal zones of spleen lymphoid follicles, widening of their germinal centers, and a decrease in the absolute number of cytotoxic T-lymphocytes, NK cells, and B-lymphocytes. After 24 hours of LPS injection the tolerant-to-hypoxia animals had a greater absolute number of T-lymphocytes and NK cells in comparison with the susceptible rats. Thus, in animals with different resistance to hypoxia the LPS-induced SIRS is characterized by different dynamics of morphological and functional changes of the thymus and spleen. The obtained data will serve as a basis for the development of new individual approaches to the prevention and treatment of infectious and inflammatory diseases.

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C-reactive protein for late-onset sepsis diagnosis in very low birth weight infants

Cited by 34 publications

References 31 publications

<p>Dependence of the severity of the systemic inflammatory response on resistance to hypoxia in male Wistar rats</p>

<p>Dependence of the severity of the systemic inflammatory response on resistance to hypoxia in male Wistar rats</p>

Antibiotic Discontinuation 24 h After Neonatal Late-Onset Sepsis Work-Up—A Validated Decision Tree Model

Morphological Characteristics of the Thymus and Spleen and the Subpopulation Composition of Lymphocytes in Peripheral Blood during Systemic Inflammatory Response in Male Rats with Different Resistance to Hypoxia

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