The use of CRP for diagnosing infections in young infants <3 months of age in developing countries

Ayo Palmer; John B. Carlin; Joachim Freihorst; Salvacion Gatchalian; Lulu Muhe; Kim Mulholland; Martin W. Weber; S. Gove; P. Margolis; F. McCaul; S. Parker; C. John; P. Byass; O. Ogunlesi; M. Manary; R. Adegbola; H. Whittle; O. Secka; B. Sam; D. Hazlett; M. Aidoo; J. Bangali; B. Greenwood; M. Tilahun; S. Lulseged; S. Kebede; A. Yohanes; B. Belete; S. Ringertz; T. Desta; K. Woldeyesus; N. Tafari; D. Lehmann; G. Saleu; A. Rongap; M. Kakazo; P. Namuigi; S. Lupiwa; R. Sehuko; A. Clegg; R. Sanders; A. Michael; T. Lupiwa; M. Omena; M. Mens; B. Marjen; P. Wai'in; M. Sungu; D. Lewis; M. Alpers; B. Quiambao; A. M. Moreles; L. Abraham; L. Sombrero; F. Palladin; V. Sariano; A. M. Obach; E. Sunico; T. Cedulla; H. Eichenwald; C. Broome; M. Gratten; P. Margolis; R. Facklam; T. Nolan

doi:10.1179/027249304225018948

The use of CRP for diagnosing infections in young infants <3 months of age in developing countries

Ayo Palmer, John B. Carlin, Joachim Freihorst, Salvacion Gatchalian, Lulu Muhe, Kim Mulholland, Martin W. Weber, S. Gove, P. Margolis, F. McCaul, S. Parker, C. John, P. Byass, O. Ogunlesi, M. Manary, R. Adegbola, H. Whittle, O. Secka, B. Sam, D. HazlettM. Aidoo, J. Bangali, B. Greenwood, M. Tilahun, S. Lulseged, S. Kebede, A. Yohanes, B. Belete, S. Ringertz, T. Desta, K. Woldeyesus, N. Tafari, D. Lehmann, G. Saleu, A. Rongap, M. Kakazo, P. Namuigi, S. Lupiwa, R. Sehuko, A. Clegg, R. Sanders, A. Michael, T. Lupiwa, M. Omena, M. Mens, B. Marjen, P. Wai'in, M. Sungu, D. Lewis, M. Alpers, B. Quiambao, A. M. Moreles, L. Abraham, L. Sombrero, F. Palladin, V. Sariano, A. M. Obach, E. Sunico, T. Cedulla, H. Eichenwald, C. Broome, M. Gratten, P. Margolis, R. Facklam, T. Nolan

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Abstract

The diagnosis of severe bacterial infection in young infants in developing countries is difficult because of the lack of sensitivity and specificity of the presenting symptoms and signs. Whether C-reactive protein (CRP) might help with the early detection of neonatal sepsis was investigated in a prospective study in The Gambia, Ethiopia and The Philippines. Infants <3 months of age with symptoms or signs of possible sepsis were evaluated; CRP was measured and assessed for its ability to predict proven invasive bacterial infection. Of 966 children <3 months of age, 54 had a positive blood culture, 13 a positive CSF culture, 15 a positive blood and CSF culture and 884 had negative cultures. Median (interquartile range) CRP values were 42 (9-173), 14 (6-36), 209 (135-286) and 8 (3-27) mg/L in the four groups, respectively. Taking a CRP cut-off of 10 mg/L, the sensitivity and specificity of an elevated CRP to predict a positive blood or CSF culture were 77% and 55%, respectively, and 55% and 82%, respectively, for a cut-off of 40 mg/L. CRP lacks the sensitivity and specificity to be used alone as a predictor of serious infections in young infants.

Original language	English
Pages (from-to)	205-212
Number of pages	8
Journal	Annals of Tropical Paediatrics
Volume	24
Issue number	3
DOIs	https://doi.org/10.1179/027249304225018948
State	Published - Sep 2004

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Palmer, A., Carlin, J. B., Freihorst, J., Gatchalian, S., Muhe, L., Mulholland, K., Weber, M. W., Gove, S., Margolis, P., McCaul, F., Parker, S., John, C., Byass, P., Ogunlesi, O., Manary, M., Adegbola, R., Whittle, H., Secka, O., Sam, B., ... Nolan, T. (2004). The use of CRP for diagnosing infections in young infants <3 months of age in developing countries. Annals of Tropical Paediatrics, 24(3), 205-212. https://doi.org/10.1179/027249304225018948

@article{bc2703b1012a4fc2adff9d4c90eb57e3,

title = "The use of CRP for diagnosing infections in young infants <3 months of age in developing countries",

abstract = "The diagnosis of severe bacterial infection in young infants in developing countries is difficult because of the lack of sensitivity and specificity of the presenting symptoms and signs. Whether C-reactive protein (CRP) might help with the early detection of neonatal sepsis was investigated in a prospective study in The Gambia, Ethiopia and The Philippines. Infants <3 months of age with symptoms or signs of possible sepsis were evaluated; CRP was measured and assessed for its ability to predict proven invasive bacterial infection. Of 966 children <3 months of age, 54 had a positive blood culture, 13 a positive CSF culture, 15 a positive blood and CSF culture and 884 had negative cultures. Median (interquartile range) CRP values were 42 (9-173), 14 (6-36), 209 (135-286) and 8 (3-27) mg/L in the four groups, respectively. Taking a CRP cut-off of 10 mg/L, the sensitivity and specificity of an elevated CRP to predict a positive blood or CSF culture were 77% and 55%, respectively, and 55% and 82%, respectively, for a cut-off of 40 mg/L. CRP lacks the sensitivity and specificity to be used alone as a predictor of serious infections in young infants.",

author = "Ayo Palmer and Carlin, {John B.} and Joachim Freihorst and Salvacion Gatchalian and Lulu Muhe and Kim Mulholland and Weber, {Martin W.} and S. Gove and P. Margolis and F. McCaul and S. Parker and C. John and P. Byass and O. Ogunlesi and M. Manary and R. Adegbola and H. Whittle and O. Secka and B. Sam and D. Hazlett and M. Aidoo and J. Bangali and B. Greenwood and M. Tilahun and S. Lulseged and S. Kebede and A. Yohanes and B. Belete and S. Ringertz and T. Desta and K. Woldeyesus and N. Tafari and D. Lehmann and G. Saleu and A. Rongap and M. Kakazo and P. Namuigi and S. Lupiwa and R. Sehuko and A. Clegg and R. Sanders and A. Michael and T. Lupiwa and M. Omena and M. Mens and B. Marjen and P. Wai'in and M. Sungu and D. Lewis and M. Alpers and B. Quiambao and Moreles, {A. M.} and L. Abraham and L. Sombrero and F. Palladin and V. Sariano and Obach, {A. M.} and E. Sunico and T. Cedulla and H. Eichenwald and C. Broome and M. Gratten and P. Margolis and R. Facklam and T. Nolan",

year = "2004",

month = sep,

doi = "10.1179/027249304225018948",

language = "English",

volume = "24",

pages = "205--212",

journal = "Annals of Tropical Paediatrics",

issn = "0272-4936",

number = "3",

}

Palmer, A, Carlin, JB, Freihorst, J, Gatchalian, S, Muhe, L, Mulholland, K, Weber, MW, Gove, S, Margolis, P, McCaul, F, Parker, S, John, C, Byass, P, Ogunlesi, O, Manary, M, Adegbola, R, Whittle, H, Secka, O, Sam, B, Hazlett, D, Aidoo, M, Bangali, J, Greenwood, B, Tilahun, M, Lulseged, S, Kebede, S, Yohanes, A, Belete, B, Ringertz, S, Desta, T, Woldeyesus, K, Tafari, N, Lehmann, D, Saleu, G, Rongap, A, Kakazo, M, Namuigi, P, Lupiwa, S, Sehuko, R, Clegg, A, Sanders, R, Michael, A, Lupiwa, T, Omena, M, Mens, M, Marjen, B, Wai'in, P, Sungu, M, Lewis, D, Alpers, M, Quiambao, B, Moreles, AM, Abraham, L, Sombrero, L, Palladin, F, Sariano, V, Obach, AM, Sunico, E, Cedulla, T, Eichenwald, H, Broome, C, Gratten, M, Margolis, P, Facklam, R & Nolan, T 2004, 'The use of CRP for diagnosing infections in young infants <3 months of age in developing countries', Annals of Tropical Paediatrics, vol. 24, no. 3, pp. 205-212. https://doi.org/10.1179/027249304225018948

TY - JOUR

T1 - The use of CRP for diagnosing infections in young infants <3 months of age in developing countries

AU - Palmer, Ayo

AU - Carlin, John B.

AU - Freihorst, Joachim

AU - Gatchalian, Salvacion

AU - Muhe, Lulu

AU - Mulholland, Kim

AU - Weber, Martin W.

AU - Gove, S.

AU - Margolis, P.

AU - McCaul, F.

AU - Parker, S.

AU - John, C.

AU - Byass, P.

AU - Ogunlesi, O.

AU - Manary, M.

AU - Adegbola, R.

AU - Whittle, H.

AU - Secka, O.

AU - Sam, B.

AU - Hazlett, D.

AU - Aidoo, M.

AU - Bangali, J.

AU - Greenwood, B.

AU - Tilahun, M.

AU - Lulseged, S.

AU - Kebede, S.

AU - Yohanes, A.

AU - Belete, B.

AU - Ringertz, S.

AU - Desta, T.

AU - Woldeyesus, K.

AU - Tafari, N.

AU - Lehmann, D.

AU - Saleu, G.

AU - Rongap, A.

AU - Kakazo, M.

AU - Namuigi, P.

AU - Lupiwa, S.

AU - Sehuko, R.

AU - Clegg, A.

AU - Sanders, R.

AU - Michael, A.

AU - Lupiwa, T.

AU - Omena, M.

AU - Mens, M.

AU - Marjen, B.

AU - Wai'in, P.

AU - Sungu, M.

AU - Lewis, D.

AU - Alpers, M.

AU - Quiambao, B.

AU - Moreles, A. M.

AU - Abraham, L.

AU - Sombrero, L.

AU - Palladin, F.

AU - Sariano, V.

AU - Obach, A. M.

AU - Sunico, E.

AU - Cedulla, T.

AU - Eichenwald, H.

AU - Broome, C.

AU - Gratten, M.

AU - Margolis, P.

AU - Facklam, R.

AU - Nolan, T.

PY - 2004/9

Y1 - 2004/9

N2 - The diagnosis of severe bacterial infection in young infants in developing countries is difficult because of the lack of sensitivity and specificity of the presenting symptoms and signs. Whether C-reactive protein (CRP) might help with the early detection of neonatal sepsis was investigated in a prospective study in The Gambia, Ethiopia and The Philippines. Infants <3 months of age with symptoms or signs of possible sepsis were evaluated; CRP was measured and assessed for its ability to predict proven invasive bacterial infection. Of 966 children <3 months of age, 54 had a positive blood culture, 13 a positive CSF culture, 15 a positive blood and CSF culture and 884 had negative cultures. Median (interquartile range) CRP values were 42 (9-173), 14 (6-36), 209 (135-286) and 8 (3-27) mg/L in the four groups, respectively. Taking a CRP cut-off of 10 mg/L, the sensitivity and specificity of an elevated CRP to predict a positive blood or CSF culture were 77% and 55%, respectively, and 55% and 82%, respectively, for a cut-off of 40 mg/L. CRP lacks the sensitivity and specificity to be used alone as a predictor of serious infections in young infants.

AB - The diagnosis of severe bacterial infection in young infants in developing countries is difficult because of the lack of sensitivity and specificity of the presenting symptoms and signs. Whether C-reactive protein (CRP) might help with the early detection of neonatal sepsis was investigated in a prospective study in The Gambia, Ethiopia and The Philippines. Infants <3 months of age with symptoms or signs of possible sepsis were evaluated; CRP was measured and assessed for its ability to predict proven invasive bacterial infection. Of 966 children <3 months of age, 54 had a positive blood culture, 13 a positive CSF culture, 15 a positive blood and CSF culture and 884 had negative cultures. Median (interquartile range) CRP values were 42 (9-173), 14 (6-36), 209 (135-286) and 8 (3-27) mg/L in the four groups, respectively. Taking a CRP cut-off of 10 mg/L, the sensitivity and specificity of an elevated CRP to predict a positive blood or CSF culture were 77% and 55%, respectively, and 55% and 82%, respectively, for a cut-off of 40 mg/L. CRP lacks the sensitivity and specificity to be used alone as a predictor of serious infections in young infants.

UR - http://www.scopus.com/inward/record.url?scp=4844229673&partnerID=8YFLogxK

U2 - 10.1179/027249304225018948

DO - 10.1179/027249304225018948

M3 - Article

C2 - 15479569

AN - SCOPUS:4844229673

SN - 0272-4936

VL - 24

SP - 205

EP - 212

JO - Annals of Tropical Paediatrics

JF - Annals of Tropical Paediatrics

IS - 3

ER -

The use of CRP for diagnosing infections in young infants <3 months of age in developing countries

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