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


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


  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.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

November Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 15, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.