Diagnostic value of C-reactive protein test at early-onset sepsis in preterm infants

Bacterial sepsis of preterm infants is an urgent problem of pediatrics, as this population is at high risk for the development of sepsis. The aim of the present investigation was the evaluation of significance of C-reactive protein (CRP) test for identification of early-onset sepsis and assessment of the severity of infectious process. A total of 250 preterm infants, referred to the neonatal intensive care unit of M. Iashvili Central Pediatric Clinic at the first hours of life, have been studied during the period of 2002-2005. Level of C-reactive protein (CRP) was determined at first 24, 48 and 72 hours from the birth using the method of latex agglutination. Two groups of patients were separated. The first group was comprised of patients diagnosed with sepsis at the first hours of life on the basis of determination of CRP level, which was significantly elevated as compared with norm. Quantitative increase of CRP corresponded to the severity of the disease. The diagnosis has been confirmed by positive hemoculture later, after 72 hours. In patients of the second group CRP level corresponded to the normal values and the results of other examinations also indicated the absence of sepsis. In this group treatment with antibiotics was discontinued. The results of investigation allow to conclude that quantitative index of CRP is a rapid, sensitive diagnostic marker for identification of early-onset sepsis in preterm infants. Elevation of CRP level on the background of active therapy of sepsis is a negative prognostic sign. It is advisable to determine CRP level in dynamics to assess severity of the course of the disease.