Respective Study
Volume 10 Issue 8 - 2021
Utility of C-Reactive Protein and Complete Blood Count Values as Primary Screening Markers for Sepsis in Preterm Neonates: Retrospective Study from United Arab Emirates
Mohammed Farah Osman1*, Tushar Kulkarni2 and Khaled El-Atawi3
1Neonatology Fellow, NICU, Tawam Hospital, United Arab Emirates
2Specialist Neonatologist, NICU, LWCH, United Arab Emirates
3Consusltant Neonatologist, NICU, LWCH, United Arab Emirates
*Corresponding Author: Mohammed Farah Osman, Neonatology Fellow, NICU, Tawam Hospital, United Arab Emirates.
Received: July 19, 2021; Published: July 31, 2021




Abstract

Objective: To assess the diagnostic utility of CRP and CBC parameters taken on admission for early screening of neonatal sepsis in a single center from the United Arab Emirates (UAE).

Methods: A retrospective chart review was conducted to retrieve the data of all preterm infants who were admitted to Latifa Hospital in Dubai through the period from January to December 2014. Data of 471 infants (257 males, 214 females) were retrieved and analyzed.

Results: For culture-proven sepsis, CRP had a sensitivity of 60%, specificity of 90%, positive predictive value (PPV) of 19%, and negative predictive value (NPV) of 98%. For clinical sepsis, CRP had an overall sensitivity of 48.6%, overall specificity of 94%, and overall PPV and NPV values of 53.9% and 92.7%, respectively. The total leucocytic count (TLC) and absolute neutrophil count (ANC) showed an overall sensitivity of 15% and 10% for culture-proven neonatal sepsis, respectively. On the contrary, specificity numbers for TLC and ANC were decent for both culture-proven and clinical sepsis. For culture-proven sepsis, a low platelet count had a sensitivity of 55%, with a specificity of 84.5%. For clinical sepsis, low platelet count had a sensitivity of 42.9%, a specificity of 87%, and PPV and NPV values of 32.2% and 91.4% for overall neonatal sepsis. The in-hospital mortality rate was 7.6%.

Conclusion: None of the primary sepsis screening investigations has adequate sensitivity for early detection of neonatal sepsis. At the same time, CRP only exhibits decent specificity in neonates with suspected sepsis.

Keywords: Preterm; Neonatal Sepsis; C-Reactive Protein; Complete Blood Count

References

  1. Özmeral Odabaşı I and Neonatal Sepsis. “SiSli Etfal Hastan Tip Bul”. The Medical Bulletin of Sisli Etfal Hospital 54 (2020): 142.
  2. Glaser MA., et al. “Neonatal Sepsis: A Review of Pathophysiology and Current Management Strategies”. Advances in Neonatal Care 21 (2021): 49-60.
  3. Fleischmann C., et al. “Global incidence and mortality of neonatal sepsis: A systematic review and meta-analysis”. Archives of Disease in Childhood (2021): 1-8.
  4. Hammoud MS., et al. “Late-onset neonatal sepsis in Arab states in the Gulf region: two-year prospective study (2017).
  5. Shane AL., et al. “Neonatal sepsis”. Lancet 390 (2017): 1770-1780.
  6. Stoll BJ., et al. “Early onset neonatal sepsis: The burden of group B streptococcal and E. coli disease continues”. Pediatrics 127 (2011): 817-826.
  7. Dong Y and Speer CP. “Late-onset neonatal sepsis: Recent developments”. Archives of Disease in Childhood. Fetal and Neonatal 100 (2015): F257-263.
  8. Singh M., et al. “Neonatal Sepsis”. Stat Pearls Publishing (2021).
  9. Aggarwal R., et al. “Sepsis in the newborn”. Indian Journal of Pediatrics 68 (2001): 1143-1147.
  10. Gerdes JS. “Diagnosis and management of bacterial infections in the neonate”. Pediatric Clinics of North America 51 (2004): 939-959.
  11. Neto MT. “Group B streptococcal disease in Portuguese infants younger than 90 days”. Pediatric Clinics of North America (2008): 93.
  12. Hengst JM. “The role of C-reactive protein in the evaluation and management of infants with suspected sepsis”. Advances in Neonatal Care 3 (2003): 3-13.
  13. Franz AR., et al. “Reduction of unnecessary antibiotic therapy in newborn infants using interleukin-8 and C-reactive protein as markers of bacterial infections”. Pediatrics 104 (1999): 447-453.
  14. Von Elm E., et al. “The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies”. International Journal of Surgery (2014).
  15. Declaration of Helsinki World Medical Association Declaration of Helsinki”. The Bulletin of the World Health Organization 79 (2013): 373-374.
  16. Ismail AQT and Gandhi A. “Using CRP in neonatal practice”. Journal of Maternal-Fetal and Neonatal Medicine 28 (2015): 3-6.
  17. Celik IH., et al. “What are the cut-off levels for IL-6 and CRP in neonatal sepsis?” Journal of Clinical Laboratory Analysis 24 (2010): 407-412.
  18. Philip AG and Mills PC. “Use of C-reactive protein in minimizing antibiotic exposure: experience with infants initially admitted to a well-baby nursery”. Pediatrics (2000): 106.
  19. Chan DKL and Ho LY. “Usefulness of C-Reactive Protein in the Diagnosis of Neonatal Sepsis”. Singapore Medical Journal 38 (1997): 252-255.
  20. Mannan MA., et al. “Utility of C-reactive protein and hematological parameters in the detection of neonatal sepsis”. Mymensingh Medical Journal 19 (2010): 259-263.
  21. Hornik CP., et al. “Use of the complete blood cell count in late-onset neonatal sepsis”. The Pediatric Infectious Disease Journal 31 (2012): 803-807.
  22. Newman TB., et al. “Interpreting complete blood counts soon after birth in newborns at risk for sepsis”. Pediatrics 126 (2010): 903-909.
Citation: Mohammed Farah Osman., et al. “Impact of Collagen Disorders on the Formation of Gastroduodenal Pathology in Children and Adolescents”. EC Paediatrics 10.8 (2021): 89-96.

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