The cost-effectiveness and value of C-reactive protein in the diagnosis and management of neonatal late-onset sepsis in resource-limited settings

J Chandramati, S Ponthenkandath
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Abstract

Background. Although C-reactive protein (CRP) is used as a biomarker, its value in resource-limited settings for diagnosis andmanagement of late-onset sepsis in neonates has not been reported previously.Objective. To evaluate the value of CRP as a biomarker in identifying late-onset sepsis in symptomatic infants.Method. We performed a retrospective study to evaluate the value of CRP as a biomarker in identifying late-onset sepsis in symptomatic infants. Infants were classified into three groups (blood culture-proven sepsis (n=72), clinical sepsis (n=38) and no sepsis (n=114)). Infants underwent sepsis work-up consisting of complete blood count (CBC), blood culture, urine and cerebrospinal fluid (CSF) culture including CRP measurements.Results. The overall sensitivity and specificity of CRP levels >10 μg/mL was 94.5% and 91.2%, respectively, for the diagnosis of late-onset sepsis. Positive predictive value was 91.2% and negative predictive value was 92.8%. Total white blood cell (WBC) counts had poorsensitivity and specificity compared with CRP. The cost for CRP testing was only 2.5% of the total cost for sepsis work-up in neonates.Conclusion. Our study indicates that CRP has excellent sensitivity and specificity in the diagnosis of late-onset sepsis. In low- and middle-income countries, CRP testing perhaps offers more value compared with W14BC counts
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在资源有限的情况下,c反应蛋白在诊断和管理新生儿迟发性败血症中的成本效益和价值
背景。虽然c反应蛋白(CRP)被用作一种生物标志物,但其在资源有限的情况下对新生儿迟发性败血症的诊断和管理的价值尚未见报道。评价CRP作为一种生物标志物在鉴别有症状婴儿迟发性脓毒症中的价值。我们进行了一项回顾性研究,以评估CRP作为识别有症状婴儿迟发性败血症的生物标志物的价值。将婴儿分为血培养证实的脓毒症(72例)、临床脓毒症(38例)和非脓毒症(114例)三组。婴儿接受败血症检查,包括全血细胞计数(CBC)、血培养、尿和脑脊液(CSF)培养,包括CRP测量。CRP水平≤10 μg/mL诊断晚发型脓毒症的总体敏感性为94.5%,特异性为91.2%。阳性预测值为91.2%,阴性预测值为92.8%。总白细胞(WBC)计数与CRP相比敏感性和特异性较差。CRP检测费用仅占新生儿败血症检查总费用的2.5%。我们的研究表明,CRP在诊断迟发性败血症方面具有优异的敏感性和特异性。在低收入和中等收入国家,CRP检测可能比W14BC计数更有价值
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CiteScore
0.60
自引率
0.00%
发文量
21
审稿时长
12 weeks
期刊最新文献
Low birthweight and maternal smoking as predictors of infant lung function from a South African birth cohort within low socioeconomic communities An audit of electronic discharge summaries of neonates admitted with hypoxic ischaemic encephalopathy to tertiary hospitals in [City], 2018–2019. Borderline hypernatraemia and mortality rates in South African infants: A single-centre observational study The cost-effectiveness and value of C-reactive protein in the diagnosis and management of neonatal late-onset sepsis in resource-limited settings Issue 4
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