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[Proteins of the "acute-phase" in prematures and newborns (author's transl)]
Insights
C-reactive protein (CRP) is the most reliable indicator for detecting bacterial infections in newborns, even premature infants. Haptoglobin (Hp) levels were often elevated in healthy newborns, making it less specific for infection diagnosis.
Area of Science:
- Neonatal medicine
- Clinical chemistry
- Immunology
Context:
- Neonatal infections pose significant risks to infant health.
- Acute phase proteins (p.a.p.) are biomarkers used to detect inflammation and infection.
- Accurate and early diagnosis of bacterial infections in newborns is critical.
Purpose:
- To evaluate the diagnostic utility of three acute phase proteins (CRP, Hp, and alpha 1-Glycoprotein) for detecting bacterial infections in neonates.
- To compare the effectiveness of CRP, Hp, and alpha 1-Glycoprotein in identifying infections in both premature and full-term newborns.
Summary:
- Serum levels of CRP, Hp, and alpha 1-Glycoprotein were measured in 113 neonates within the first 10 days of life.
- Elevated CRP and Hp were observed in infants with confirmed or suspected septicemia.
- While Hp was frequently elevated in healthy neonates, CRP proved to be a more specific marker for bacterial infections, unaffected by transfusions or age.
Impact:
- CRP is identified as the most suitable acute phase protein for diagnosing bacterial infections in newborns, including premature infants.
- This finding supports the use of CRP as a valuable tool for early detection and management of neonatal infections.
- The study highlights the limitations of Hp as a sole diagnostic marker due to its non-specific elevation in neonates.
Abstract:
Three proteins of the "acute phase" (p.a.p.) were determined in the serum of 113 premature and newborns during the first 10 days of life. In all 13 cases with septicemia or severe infection high levels of c-reactive protein (CRP) and haptoglobin (Hp) were found, in 22 babies with suspected infection elevated CRP- and Hp-concentrations were found 13 and 14 times respectively. In 73 healthy newborns low levels of CRP were detectable 6 times, Hp however, was markedly elevated 25 times. Nutrition or injuries did not influence the production of Hp. The concentration of the third p.a.p. the acid alpha 1-Glycoprotein, in serum of sick and healthy neonates did not differ markedly. The indirect proof of bacterial infections by the p.a.p. is possible even in prematures under 1000 g and generally soon after the contact with pathogenes, for example in the cordblood after a previous rupture of membranes. Since CRP is the only p.a.p., that is not increased by transfusion or by age, it is by far the most suitable of the three examined p.a.p. for the detection of bacterial infections in newborn.