Division of Neonatology, Neonatal Intensive Care Unit, Mersin Maternal and Child Health Hospital, 33240 Mersin, Turkey.
Eur J Pediatr. 2013 Jun;172(6):839-42. doi: 10.1007/s00431-013-1946-2. Epub 2013 Jan 29.
Hepatitis B virus (HBV) infection continues to be a serious global health problem. During the course of HBV vaccination, we observed C-reactive protein (CRP) elevation in term infants without sepsis. Therefore, we prospectively studied interleukin-6 (IL-6) and CRP responses to HBV immunization. In 70 healthy term infants without signs and symptoms of sepsis and sepsis risk factors, IL-6, CRP, and white blood cell count levels were determined before and 24 h after immunization. Significant increases in CRP levels were seen 24 h after vaccination (p < 0.001). Although CRP levels of 22 infants at second evaluation were above the cutoff level for sepsis (4.82 mg/L), they had no clinical signs and symptoms of sepsis. After 48-72 h, CRP levels of these infants returned to normal levels with no blood culture positivity.
our study showed that HBV vaccine is responsible for CRP elevation in term infants after vaccination at birth. To the best of our knowledge, this is the first study evaluating CRP response to HBV vaccine at birth in term infants. We suggest that this response should be considered in differentiation of early neonatal sepsis to avoid unnecessary antibiotic use.
乙型肝炎病毒（HBV）感染仍然是一个严重的全球健康问题。在 HBV 疫苗接种过程中，我们观察到足月婴儿在没有败血症的情况下 C 反应蛋白（CRP）升高。因此，我们前瞻性研究了白细胞介素-6（IL-6）和 CRP 对 HBV 免疫接种的反应。在 70 名无败血症和败血症危险因素的健康足月婴儿中，在免疫接种前和接种后 24 小时测定了 IL-6、CRP 和白细胞计数水平。接种后 24 小时 CRP 水平显著升高（p<0.001）。尽管第二次评估时 22 名婴儿的 CRP 水平高于败血症的临界值（4.82 mg/L），但他们没有败血症的临床症状和体征。48-72 小时后，这些婴儿的 CRP 水平恢复正常，无血培养阳性。
我们的研究表明，HBV 疫苗是足月婴儿出生后接种疫苗后 CRP 升高的原因。据我们所知，这是第一项评估足月婴儿出生时 HBV 疫苗对 CRP 反应的研究。我们建议，在鉴别新生儿早期败血症时应考虑这种反应，以避免不必要的使用抗生素。
