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The Role of C-Reactive Protein and Implications to the Neonatal Intensive Care Unit

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Biomarkers in Trauma, Injury and Critical Care

Abstract

As neonatal infections are difficult to diagnose with accuracy and have a high prevalence with serious long-term consequences, biomarkers of infection have been widely studied to improve the diagnostic accuracy and reduce antibiotic exposure in patients who are not infected. C-reactive protein (CRP) is a serum protein that increases in the blood in response to inflammatory or infective triggers. The function of CRP is important in the humoral response to bacterial infection during the acute phase, and it has been widely used as a marker of severe bacterial infection in both adults and children; however, as a result of its delayed synthesis, the sensitivity during the earliest phases of infection is poor, and it may rise in response to other non-infectious triggers. Its accuracy and negative predictive value to rule out infection increase over time with serial investigations. In this review, we discuss the kinetics of CRP, its role in the diagnosis of infection in the neonate, factors that may affect its measurement, and its usefulness in monitoring the response to treatment in the infected neonate.

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Abbreviations

CRP:

C-reactive protein

ELBW :

Extreme low birth weight

EONS :

Early-onset neonatal sepsis

hsCRP:

High-sensitivity C-reactive protein

IL-1 :

Interleukin-1

IL-6 :

Interleukin-6

LONS :

Late-onset neonatal sepsis

nCD64 :

Neutrophil CD64 percentage

NICU :

Neonatal intensive care unit

PCT :

Procalcitonin

POC :

Point of care

RCT :

Randomized controlled trial

ROC :

Receiver operator characteristic curve

SNAP :

Score for neonatal acute physiology

VLBW :

Very low birth weight

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Author information

Authors and Affiliations

  1. Department of Paediatrics, Division of Neonatal Medicine, University of Cape Town, Cape Town, South Africa

    Yaseen Joolay

  2. Melomed Gatesville Private Hospital, Cape Town, South Africa

    Shukri Raban

  3. Pathcare Laboratories, Cape Town, South Africa

    Johan van Wyk & Fierdoz Omar

Authors
  1. Yaseen Joolay
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  2. Shukri Raban
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  3. Johan van Wyk
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  4. Fierdoz Omar
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Corresponding author

Correspondence to Yaseen Joolay .

Editor information

Editors and Affiliations

  1. College of Medicine, King Saud bin Abdulaziz University of Health Sciences, Riyadh, Saudi Arabia

    Rajkumar Rajendram

  2. School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK

    Victor R. Preedy

  3. School of Life Sciences, University of Westminster, London, UK

    Vinood B. Patel

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Joolay, Y., Raban, S., van Wyk, J., Omar, F. (2023). The Role of C-Reactive Protein and Implications to the Neonatal Intensive Care Unit. In: Rajendram, R., Preedy, V.R., Patel, V.B. (eds) Biomarkers in Trauma, Injury and Critical Care. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Cham. https://doi.org/10.1007/978-3-031-07395-3_9

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