title: C-Reactive Protein, Detected with a Highly Sensitive Assay, in Non-Infected Newborns and Those with Early Onset Infection.
abstract: SUMMARY: BACKGOUND: The aim of this study was to investigate C-reactive protein (CRP), measured by a highly sensitive method (hsCRP) in non-infected newborns and in those with suspected early onset bacterial infection (EOBI) as well as to test whether EOBI would be detectable earlier by hsCRP than by a nephelometric CRP (nsCRP) assay (thresholds > 10 mg/l) or IL-8. PATIENTS AND METHODS: 106 neonates with signs of infection comprised the suspected EOBI group. 134 neonates with risk factors but confirmed exclusion of EOBI served as non-infected controls. RESULTS: In the non-infected group, hsCRP in the first 6 h after birth was low (0.7 mg/l; SD 0.16 mg/l) but showed an increase to 4.11 mg/l (SD 3.33 mg/l) at 72 h (p < 0.001 vs. 6 h). The sensitivity of hsCRP (cut-off 0.3 mg/l) vs. nsCRP for EOBI was 0.46 vs. 0.23 at 6 h after clinical suspicion. Of all parameters measured, IL-8 had the highest sensitivity and specificity to detect EOBI at 6 h (0.60 and 0.90), but declined after 12 and 24 h. CONCLUSION: Lowering the CRP detection threshold by a highly sensitive assay did not improve diagnostic accuracy for EOBI.
authors.affiliation: Department of Neonatology, University Childrens' Hospital, Germany.
authors.forename: Melanie
authors.initials: M
authors.lastname: Muenzenmaier
authors.forename: Marita
authors.initials: M
authors.lastname: Depperschmid
authors.forename: Christian
authors.initials: C
authors.lastname: Gille
authors.forename: Christian F
authors.initials: CF
authors.lastname: Poets
authors.forename: Thorsten W
authors.initials: TW
authors.lastname: Orlikowsky