Skip to main content
Log in

C-reactive protein and bacterial infection in preterm infants

European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Serum C-reactive protein (CRP) concentration was measured by a new solid phase ligand-binding radiometric monoclonal antibody immunoassay in a prospective study of 193 consecutively born preterm infants. In 104 with no clinical or laboratory evidence of infection the median CRP in cord serum was 0.125 mg/l (range 0.011–6.0 mg/l), at 24 h it was 1 mg/l (0.016–7.0) and at 48 h 2 mg/l (0.400–8.0). The present highly sensitive assay has enabled these normal ranges to be defined for the first time, at levels below the threshold of non-labelled immunoassays and of all commercially available CRP assays. The values in cord serum were significantly lower than in normal healthy adults (median 0.8 mg/l, range 0.07–29 mg/l,n=468) [20]. Arterial catheterisation and endotracheal intubation, in the absence of infection, did not appear to elevate CRP, nor did cerebral germinal layer or intraventricular haemorrhage. Among nine infants with confirmed septicaemia eight had a serum CRP level raised at least once during the first 48 h and serum CRP in the other one increased 250-fold in 24 h before treatment was started. Using this assay, serum CRP is a useful and rapidly available adjunct to clinical assessment in diagnosis and exclusion of bacterial infection in the early neonatal period, has encouraged us to withhold or discontinue antibiotics and also has a role in monitoring response to treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abbreviations

CRP:

C-reactive protein

References

  1. Adhikari M, Coovadia HM, Coovadia YM, Smit SY, Moosa A (1986) Predictive value of C-reactive protein in neonatal septicaemia. Ann Trop Paediatr 6:37–40

    PubMed  Google Scholar 

  2. Bennish M, Beem MO, Ormiste V (1984) C-reactive protein and zeta sedimentation ratio as indicators of bacteremia in pediatric patients. J Pediatr 104:729–732

    PubMed  Google Scholar 

  3. Cox ML, Rudd AG, Gallimore R, Hodkinson HM, Pepys MB (1986) Real-time measurement of serum C-reactive protein in the management of infection in the elderly. Age Ageing 15:257–266

    PubMed  Google Scholar 

  4. Forest J-C, Lariviere F, Dolce P, Masson M, Nadeau L (1986) C-reactive protein as biochemical indicator of bacterial infection in neonates. Clin Biochem 19:192–194

    Article  PubMed  Google Scholar 

  5. Hind CRK, Pepys MB (1987) Acute phase proteins. In: Lessof MH, Lee TH, Kemeny DM (eds) Allergy: an international textbook. Wiley, New York, pp 237–253

    Google Scholar 

  6. Kushner I, Broder ML, Karp D (1978) Control of the acute phase response. Serum C-reactive protein kinetics after acute myocardial infarction. J Clin Invest 61:235–242

    PubMed  Google Scholar 

  7. Lloyd BW, Oto A (1982) Normal values for mature and immature neutrophils in very preterm babies. Arch Dis Child 57:233–235

    PubMed  Google Scholar 

  8. Magny J-F, Benattar C, Saby M-A, Lindenbaum A, Dehan M, Gabilan J-C (1986) C reactive proteine et diagnostic d'infection neonatale. Pediatrie 41:105–108

    PubMed  Google Scholar 

  9. Manroe BL, Weinberg AG, Rosenfeld CR, Browne R (1979) The neutrophil blood count in health and disease 1. Reference values for neutrophil cells. J Pediatr 95:89–98

    PubMed  Google Scholar 

  10. Mathers NJ, Pohlandt F (1987) Diagnostic audit of C-reactive protein in neonatal infection. Eur J Pediatr 146:147–151

    PubMed  Google Scholar 

  11. Nudelman R, Kagan BM (1983) C-reactive protein in pediatrics. Adv Pediatr 30:517–547

    PubMed  Google Scholar 

  12. Peeters H (ed) (1986) Protides of the biological fluids, vol 34. Pergamon Press, Oxford

    Google Scholar 

  13. Pepys MB (1987) The acute phase response and C-reactive protein. In: Weatherall DJ, Ledingham JGG, Warrel DA (eds) Oxford textbook of medicine, 2nd edn, Oxford University Press, Oxford, pp 9157–9164

    Google Scholar 

  14. Pepys MB, Baltz ML (1983) Acute phase proteins with special reference to C-reactive protein and related proteins (pentraxins) and serum amyloid A protein. Adv Immunol 34:141–212

    PubMed  Google Scholar 

  15. Philip AGS (1985) Neonatal sepsis and meningitis. Hall, Boston

    Google Scholar 

  16. Philip AGS (1985) Response of C-reactive protein in neonatal Group B streptococcal infection. Pediatr Infect Dis 4:145–148

    PubMed  Google Scholar 

  17. Placzek M, Whitelaw A (1983) Early and late neonatal septicaemia. Arch Dis Child 58:728–731

    PubMed  Google Scholar 

  18. Salzer HR, Genger H, Muhar U, Lischka A, Schatten Chr, Pollak A (1987) C-reactive protein: an early marker for neonatal bacterial infection due to prolonged rupture of aminiotic membranes and/or amnionitis. Acta Obstet Gynecol Scand 66:365–367

    PubMed  Google Scholar 

  19. Sann L, Bienvenu F, Bienvenu J, Bourgeois J, Bethenod M (1984) Evolution of serum prealbumin, C-reactive protein, and orosomucoid in neonates with bacterial infection. J Pediatr 105:977–981

    PubMed  Google Scholar 

  20. Shine B, Beer FC de, Pepys MB (1981) Solid phase radioimmunoassays for C-reactive protein. Clin Chim Acta 117:13–23

    Article  PubMed  Google Scholar 

  21. Shine B, Gould J, Campbell C, Hindocha P, Pitcher Wilmot R, Wood CBS (1985) Serum C-reactive protein in normal and infected neonates. Clin Chim Acta 148:97–103

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wasunna, A., Whitelaw, A., Gallimore, R. et al. C-reactive protein and bacterial infection in preterm infants. Eur J Pediatr 149, 424–427 (1990). https://doi.org/10.1007/BF02009664

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02009664

Key words

Navigation