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CRP levels in extremely low birth weight (ELBW) septic infants
K Dritsakou1, G Liosis, M Gioni
1NICU and.
Insights
C-reactive protein (CRP) levels in extremely low birth weight (ELBW) infants with sepsis are comparable to full-term infants but show a 24-hour delay in peak levels. Bacterial type significantly impacts CRP response in ELBW infants.
Area of Science:
- Neonatalogy
- Pediatric Infectious Diseases
- Biomarker Research
Background:
- Sepsis is a critical concern in extremely low birth weight (ELBW) infants.
- Accurate and timely diagnostic markers are essential for managing neonatal sepsis.
- C-reactive protein (CRP) is a commonly used inflammatory marker.
Purpose of the Study:
- To evaluate the diagnostic validity of C-reactive protein (CRP) in extremely low birth weight (ELBW) infants.
- To compare CRP kinetics in ELBW infants with sepsis to full-term infants.
- To investigate factors influencing CRP levels, including birth weight and causative microorganisms.
Main Methods:
- A retrospective study of 483 infants diagnosed with probable or definite sepsis over five years.
- Analysis of C-reactive protein (CRP) levels based on birth weight categories (<1000 g vs. >2500 g).
- Comparison of CRP levels between early-onset and late-onset sepsis, and by Gram-positive vs. Gram-negative infections.
Main Results:
- Extremely low birth weight (ELBW) infants with definite sepsis exhibited CRP levels comparable to full-term infants (p=0.992).
- Peak CRP values occurred at 48 hours post-septic workup in infants <1000 g birth weight, versus 24 hours in infants >2500 g.
- Gram-negative bacterial infections were associated with significantly higher CRP levels compared to Gram-positive infections.
Conclusions:
- C-reactive protein (CRP) levels in extremely low birth weight (ELBW) infants (<1000 g) with sepsis rise to levels comparable to full-term infants.
- A notable 24-hour delay in peak CRP levels is observed in ELBW infants compared to their full-term counterparts.
- The type of causative microorganism (Gram-negative vs. Gram-positive) significantly influences CRP response in neonatal sepsis.
Objective:
Testing the validity of C-reactive protein (CRP) in extremely low birth weight (ELBW) infants.
Methods:
During a five-year period, 483 infants with probable (36%) and definite sepsis (64%) were enrolled in the study.
Results:
ELBW infants with definitive sepsis had CRP levels comparable with full-terms (p=0.992). However, the highest (hs) values were observed in infants >2500 g, 24 h after the septic work up whereas in those with birth weight (BW) <1000 g after 48 h. Highest CRP levels of infants with early sepsis were similar to those of the late onset ones (p=0.825). The causative microorganism had a strong influence on CRP values, as Gram negative germs produced significantly higher CRP levels in comparison to infants with Gram positive sepsis.
Conclusions:
Highest CRP values in <1000 g infants increase in levels comparable to full terms, but with a 24-h delay.
