C reactive protein in healthy term newborns during the first 48 hours of life

Perrone, Serafina; Lotti, Federica; Longini, Mariangela; Rossetti, Annalisa; Mandalà, Marco; Bazzini, Francesco; Belvisi, Elisa; Sarnacchiaro, Pasquale; Scapellato, Carlo; Buonocore, Giuseppe

doi:10.1136/archdischild-2016-312506

Cited by 54 publications

(57 citation statements)

References 24 publications

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“…It has previously been suggested that prenatal exposure to meconium may be a cause of increased CRP concentrations . We did not find that meconium stained amniotic fluid affected the neonatal CRP values, possibly since the meconium staining was moderate and the infants had no symptoms of meconium aspiration.…”

Section: Discussioncontrasting

confidence: 64%

Serum concentrations of C‐reactive protein in healthy term‐born Norwegian infants 48–72 hours after birth

et al. 2018

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Section: Discussioncontrasting

confidence: 64%

Serum concentrations of C‐reactive protein in healthy term‐born Norwegian infants 48–72 hours after birth

et al. 2018

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“…CRP is the most extensively studied acute-phase reactant in neonates. It is widely available and its determination is simple, fast, and cost-effective ( 54 , 55 ). The mean CRP level in healthy term infants undergoes a physiological rise from ~1 mg/L at 12 h of age to ~4 mg/L at 48 h of life ( 55 ).…”

Section: Efficient Sepsis Care—basic Elementsmentioning

confidence: 99%

Culture-Negative Early-Onset Neonatal Sepsis — At the Crossroad Between Efficient Sepsis Care and Antimicrobial Stewardship

et al. 2018

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Sepsis is a leading cause of mortality and morbidity in neonates. Presenting clinical symptoms are unspecific. Sensitivity and positive predictive value of biomarkers at onset of symptoms are suboptimal. Clinical suspicion therefore frequently leads to empirical antibiotic therapy in uninfected infants. The incidence of culture confirmed early-onset sepsis is rather low, around 0.4–0.8/1000 term infants in high-income countries. Six to 16 times more infants receive therapy for culture-negative sepsis in the absence of a positive blood culture. Thus, culture-negative sepsis contributes to high antibiotic consumption in neonatal units. Antibiotics may be life-saving for the few infants who are truly infected. However, overuse of broad-spectrum antibiotics increases colonization with antibiotic resistant bacteria. Antibiotic therapy also induces perturbations of the non-resilient early life microbiota with potentially long lasting negative impact on the individual‘s own health. Currently there is no uniform consensus definition for neonatal sepsis. This leads to variations in management. Two factors may reduce the number of culture-negative sepsis cases. First, obtaining adequate blood cultures (0.5–1 mL) at symptom onset is mandatory. Unless there is a strong clinical or biochemical indication to prolong antibiotics physician need to trust the culture results and to stop antibiotics for suspected sepsis within 36–48 h. Secondly, an international robust and pragmatic neonatal sepsis definition is urgently needed. Neonatal sepsis is a dynamic condition. Rigorous evaluation of clinical symptoms (“organ dysfunction”) over 36–48 h in combination with appropriately selected biomarkers (“dysregulated host response”) may be used to support or refute a sepsis diagnosis.

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“…31 Specificity values are higher, consistently reported as >90%, even though elevations of CRP can be caused by uninfectious inflammatory processes, such as meconium aspiration and prolonged transition. 32 In both LOS and EOS, accuracy of CRP as a diagnostic marker improves with serial measurements. 31,33 Using CRP in combination with other biomarkers, particularly those that rise early in the course of infection, such as nCD64, IL6, or IL8, has also been shown to be beneficial and can be useful in tracking response to treatment.…”

Section: C-reactive Protein (Crp)mentioning

confidence: 99%

<p>Neonatal sepsis biomarkers: where are we now?</p>

Gilfillan¹,

Bhandari²

2019

RRN

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Given that neonatal sepsis remains an important factor contributing to mortality and morbidity in neonates, identification of accurate biomarkers to aid in its timely and accurate diagnosis is critical. In this review, we discuss the current evidence behind the use of biomarkers commonly used in clinical practice, as well as presenting recent developments in this area of research. Besides summarizing information regarding "traditional" biomarkers (eg, hematological indices, CRP, and other acute-phase reactants, cytokines), we provide the latest clinical status on some relatively "newer" biomarkers (eg, PCR-and "-omic" technology-based, biophysical biomarkers) in the diagnosis of neonatal sepsis. We believe that certain biophysical (RALIS, core-peripheral temperature differences) in combination with selective biochemical (procalcitonin, nCD64, presepsin) markers offer the best likelihood of being adopted for clinical use in the detection of neonatal sepsis in the near future. In addition, serial measurements of selective biochemical markers (procalcitonin, nCD64) offer promise in the decision to initiate and/or control the duration of antibiotic therapy. It is important to conduct adequately powered prospective multicenter studies to continue to establish the accuracy and safety of utilizing such biomarkers of neonatal sepsis so that appropriate and adequate therapy is tailored to each infant for optimal outcomes.

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C reactive protein in healthy term newborns during the first 48 hours of life

Abstract: Postnatal age and mode of delivery significantly influence CRP values. Reliable reference values are crucial in order to obtain an adequate diagnostic accuracy.

Cited by 54 publications

References 24 publications

Serum concentrations of C‐reactive protein in healthy term‐born Norwegian infants 48–72 hours after birth

Serum concentrations of C‐reactive protein in healthy term‐born Norwegian infants 48–72 hours after birth

Culture-Negative Early-Onset Neonatal Sepsis — At the Crossroad Between Efficient Sepsis Care and Antimicrobial Stewardship

<p>Neonatal sepsis biomarkers: where are we now?</p>

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