Am J Perinatol 2015; 32(13): 1281-1286
DOI: 10.1055/s-0035-1555127
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Preterm Infants Can Mount Appropriate C-Reactive Protein Responses to Early Onset Sepsis

Sanket D. Shah
1   Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
,
Ajay J. Talati
1   Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
2   Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee
,
Mohamad T. Elabiad
1   Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
,
Ramasubbareddy Dhanireddy
1   Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
2   Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee
,
Massroor Pourcyrous
1   Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
2   Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee
3   Department of Physiology, University of Tennessee Health Science Center, Memphis, Tennessee
› Author Affiliations
Further Information

Publication History

07 January 2015

13 May 2015

Publication Date:
12 June 2015 (online)

Abstract

Objective This study aims to evaluate whether infants born at ≤ 32 weeks' gestational age (GA) can mount C-reactive protein (CRP) responses during early onset bacterial sepsis that are comparable to infants born at > 32 weeks' GA.

Methods Retrospectively (2003–2012) infants with a positive bacterial culture during the first 72 hours of life were identified and grouped into two categories based on their GA: ≤ 32 weeks (group A) and > 32 weeks (group B).

Results Group A included 25 and group B included 122 infants. Both groups responded similarly to sepsis with an increase in CRP (p = 0.59). Each group had a significant change in intragroup CRP levels over time (p < 0.0001). However, in both groups, the degree of this change was at the same rate over time (p = 0.74).

Conclusion CRP responses to bacterial sepsis during the first 72 hours of life in infants born at ≤ 32 weeks' GA are comparable to infants born at > 32 weeks' GA.

 
  • References

  • 1 Fanaroff AA, Stoll BJ, Wright LL , et al; NICHD Neonatal Research Network. Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol 2007; 196 (2) 147.e1-147.e8
  • 2 Connell TG, Rele M, Cowley D, Buttery JP, Curtis N. How reliable is a negative blood culture result? Volume of blood submitted for culture in routine practice in a children's hospital. Pediatrics 2007; 119 (5) 891-896
  • 3 Philip AG, Mills PC. Use of C-reactive protein in minimizing antibiotic exposure: experience with infants initially admitted to a well-baby nursery. Pediatrics 2000; 106 (1) E4
  • 4 Rønnestad A, Abrahamsen TG, Gaustad P, Finne PH. C-reactive protein (CRP) response patterns in neonatal septicaemia. APMIS 1999; 107 (6) 593-600
  • 5 Chirico G, Loda C. Laboratory aid to the diagnosis and therapy of infection in the neonate. Pediatr Rep 2011; 3 (1) e1
  • 6 Hofer N, Zacharias E, Müller W, Resch B. An update on the use of C-reactive protein in early-onset neonatal sepsis: current insights and new tasks. Neonatology 2012; 102 (1) 25-36
  • 7 Benitz WE, Han MY, Madan A, Ramachandra P. Serial serum C-reactive protein levels in the diagnosis of neonatal infection. Pediatrics 1998; 102 (4) E41
  • 8 Forest JC, Larivière F, Dolcé P, Masson M, Nadeau L. C-reactive protein as biochemical indicator of bacterial infection in neonates. Clin Biochem 1986; 19 (3) 192-194
  • 9 Pourcyrous M, Bada HS, Korones SB, Baselski V, Wong SP. Significance of serial C-reactive protein responses in neonatal infection and other disorders. Pediatrics 1993; 92 (3) 431-435
  • 10 Schmidt BK, Kirpalani HM, Corey M, Low DE, Philip AG, Ford-Jones EL. Coagulase-negative staphylococci as true pathogens in newborn infants: a cohort study. Pediatr Infect Dis J 1987; 6 (11) 1026-1031
  • 11 Chiesa C, Signore F, Assumma M , et al. Serial measurements of C-reactive protein and interleukin-6 in the immediate postnatal period: reference intervals and analysis of maternal and perinatal confounders. Clin Chem 2001; 47 (6) 1016-1022
  • 12 de Villiers WJ, Louw JP, Strachan AF, Etsebeth SM, Shephard EG, de Beer FC. C-reactive protein and serum amyloid A protein in pregnancy and labour. Br J Obstet Gynaecol 1990; 97 (8) 725-730
  • 13 Gitlin D, Biasucci A. Development of gamma G, gamma A, gamma M, beta IC-beta IA, C 1 esterase inhibitor, ceruloplasmin, transferrin, hemopexin, haptoglobin, fibrinogen, plasminogen, alpha 1-antitrypsin, orosomucoid, beta-lipoprotein, alpha 2-macroglobulin, and prealbumin in the human conceptus. J Clin Invest 1969; 48 (8) 1433-1446
  • 14 Jaye DL, Waites KB. Clinical applications of C-reactive protein in pediatrics. Pediatr Infect Dis J 1997; 16 (8) 735-746 , quiz 746–747
  • 15 Kääpä P, Koistinen E. Maternal and neonatal C-reactive protein after interventions during delivery. Acta Obstet Gynecol Scand 1993; 72 (7) 543-546
  • 16 Chiesa C, Natale F, Pascone R , et al. C reactive protein and procalcitonin: reference intervals for preterm and term newborns during the early neonatal period. Clin Chim Acta 2011; 412 (11-12) 1053-1059
  • 17 Hofer N, Müller W, Resch B. Non-infectious conditions and gestational age influence C-reactive protein values in newborns during the first 3 days of life. Clin Chem Lab Med 2011; 49 (2) 297-302
  • 18 Polin RA ; Committee on Fetus and Newborn. Management of neonates with suspected or proven early-onset bacterial sepsis. Pediatrics 2012; 129 (5) 1006-1015
  • 19 Product manual VITROS Chemistry Products CRP Slides. Rochester, NY: Ortho-Clinical Diagnostics; 2010
  • 20 Elabiad MT, Arheart KL, Korones SB, Pourcyrous M. Adjusting for bias in C-reactive protein levels when using a vitros slide method in infants. Am J Perinatol 2014; 31 (10) 851-854
  • 21 Kawamura M, Nishida H. The usefulness of serial C-reactive protein measurement in managing neonatal infection. Acta Paediatr 1995; 84 (1) 10-13
  • 22 Doellner H, Arntzen KJ, Haereid PE, Aag S, Austgulen R. Interleukin-6 concentrations in neonates evaluated for sepsis. J Pediatr 1998; 132 (2) 295-299
  • 23 Turner MA, Power S, Emmerson AJ. Gestational age and the C reactive protein response. Arch Dis Child Fetal Neonatal Ed 2004; 89 (3) F272-F273
  • 24 Philip AG. Response of C-reactive protein in neonatal Group B streptococcal infection. Pediatr Infect Dis 1985; 4 (2) 145-148
  • 25 Franz AR, Steinbach G, Kron M, Pohlandt F. Reduction of unnecessary antibiotic therapy in newborn infants using interleukin-8 and C-reactive protein as markers of bacterial infections. Pediatrics 1999; 104 (3 Pt 1) 447-453
  • 26 Laborada G, Rego M, Jain A , et al. Diagnostic value of cytokines and C-reactive protein in the first 24 hours of neonatal sepsis. Am J Perinatol 2003; 20 (8) 491-501
  • 27 Seibert K, Yu VY, Doery JC, Embury D. The value of C-reactive protein measurement in the diagnosis of neonatal infection. J Paediatr Child Health 1990; 26 (5) 267-270
  • 28 Benitz WE. Adjunct laboratory tests in the diagnosis of early-onset neonatal sepsis. Clin Perinatol 2010; 37 (2) 421-438