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

Détails

ID Serval
serval:BIB_8769C098BD18
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Comparison of C-reactive protein and white blood cell count with differential in neonates at risk for septicaemia.
Périodique
European journal of pediatrics
Auteur(s)
Berger C., Uehlinger J., Ghelfi D., Blau N., Fanconi S.
ISSN
0340-6199
Statut éditorial
Publié
Date de publication
1995
Peer-reviewed
Oui
Volume
154
Numéro
2
Pages
138-44
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article - Publication Status: ppublish
Résumé
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.
Mots-clé
C-Reactive Protein, Critical Illness, Humans, Infant, Newborn, Leukocyte Count, Prospective Studies, Sensitivity and Specificity, Sepsis
Pubmed
Web of science
Création de la notice
25/01/2008 10:07
Dernière modification de la notice
20/08/2019 14:46
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