{"title":"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","authors":"J Chandramati, S Ponthenkandath","doi":"10.7196/sajch.2023.v17i1.1899","DOIUrl":null,"url":null,"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","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The cost-effectiveness and value of C-reactive protein in the diagnosis and management of neonatal late-onset sepsis in resource-limited settings\",\"authors\":\"J Chandramati, S Ponthenkandath\",\"doi\":\"10.7196/sajch.2023.v17i1.1899\",\"DOIUrl\":null,\"url\":null,\"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\",\"PeriodicalId\":44732,\"journal\":{\"name\":\"South African Journal of Child Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2023-10-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"South African Journal of Child Health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.7196/sajch.2023.v17i1.1899\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"South African Journal of Child Health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7196/sajch.2023.v17i1.1899","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
The cost-effectiveness and value of C-reactive protein in the diagnosis and management of neonatal late-onset sepsis in resource-limited settings
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