Comparison of C-reactive protein and white blood cell count with differential in neonates at risk for septicaemia.

Details

Serval ID
serval:BIB_8769C098BD18
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Comparison of C-reactive protein and white blood cell count with differential in neonates at risk for septicaemia.
Journal
European journal of pediatrics
Author(s)
Berger C., Uehlinger J., Ghelfi D., Blau N., Fanconi S.
ISSN
0340-6199
Publication state
Published
Issued date
1995
Peer-reviewed
Oui
Volume
154
Number
2
Pages
138-44
Language
english
Notes
Publication types: Clinical Trial ; Journal Article - Publication Status: ppublish
Abstract
We prospectively compared the diagnostic value of C-reactive protein (CRP) and white blood cell counts for detection of neonatal septicaemia. Sensitivity and specifity in receiver operating characteristics, and positive and negative predictive value of CRP and white blood cell count were compared in 195 critically ill preterm and term newborns clinically suspected of infection. Blood cultures were positive in 33 cases. During the first 3 days after birth CRP elevation (sensitivity 75%, specifity 86%), leukopenia (67%/90%), neutropenia (78%/80%) and immature to total neutrophil count (I/T) ratio (78%/73%) were good diagnostic parameters, as opposed to band forms with absolute count (84%/66%) or percentage (79%/71%), thrombocytopenia (65%/57%) and toxic granulations (44%/94%). Beyond 3 days of age elevated CRP (88%/87%) was the best parameter. Increased total (84%/66%) or percentage band count (79%/71%) were also useful. Leukocytosis (74%/56%), increased neutrophils (67%/65%), I/T ratio (79%/47%), thrombocytopenia (65%/57%) and toxic granulations had a low specifity. The positive predictive value of CRP was 32% before and 37% after 3 days of age, that of leukopenia was 37% in the first 3 days. CONCLUSION: During the first 3 days of life CRP, leukopenia and neutropenia were comparably good tests while after 3 days of life CRP was the best single test in early detection of neonatal septicaemia. Serial CRP estimations confirm the diagnosis, monitor the course of infection and the efficacy of antibiotic treatment.
Keywords
C-Reactive Protein, Critical Illness, Humans, Infant, Newborn, Leukocyte Count, Prospective Studies, Sensitivity and Specificity, Sepsis
Pubmed
Web of science
Create date
25/01/2008 10:07
Last modification date
20/08/2019 14:46
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