Kilpatrick Ryan, Greenberg Rachel, Hansen Nellie I, Shankaran Seetha, Carlo Waldemar A, Cotten C Michael, Stoll Barbara J
Division of Newborn Medicine, Tufts University School of Medicine, Boston, MA, USA.
Department of Pediatrics, Duke University, Durham, NC, USA.
J Perinatol. 2025 Jan;45(1):139-145. doi: 10.1038/s41372-024-02064-5. Epub 2024 Aug 5.
Characterize C-reactive protein (CRP) within 72 postnatal hours in early-onset sepsis (EOS).
Secondary analysis of a prospective surveillance study of neonates with EOS 2015-2017. We examined CRP use by center and neonatal characteristics, and CRP levels by time, neonatal characteristics, clinical signs, and pathogen.
CRP was obtained for 96/235 neonates with EOS, which varied by center (p < 0.001). 71/95 had CRP > 10 mg/L (1 missing). Neonatal characteristics with and without CRP did not differ. There was no relationship between CRP level and timing (p = 0.41) or neonate characteristics. Median CRP was higher with ≥5 vs <5 clinical signs (56, 23 mg/L; p = 0.002), and was not different in Gram-positive vs Gram-negative sepsis (43, 51 mg/L; p = 0.37) or preterm neonates who died vs survived (38, 28 mg/L; p = 0.37).
Among neonates with EOS, CRP use varied by center. CRP levels did not differ by time, neonate characteristics, pathogen, or death.
ClinicalTrials.gov ID Early-Onset Sepsis an NICHD/CDC Surveillance Study (EOSII): NCT02410486.
对早发型败血症（EOS）出生后72小时内的C反应蛋白（CRP）进行特征分析。
对2015 - 2017年患有EOS的新生儿进行前瞻性监测研究的二次分析。我们按中心和新生儿特征检查了CRP的使用情况，并按时间、新生儿特征、临床体征和病原体检查了CRP水平。
96/235例患有EOS的新生儿检测了CRP，各中心之间存在差异（p < 0.001）。95例中有71例CRP > 10mg/L（1例数据缺失）。检测和未检测CRP的新生儿特征无差异。CRP水平与检测时间（p = 0.41）或新生儿特征之间无关联。临床体征≥5项与<5项的患儿，CRP中位数更高（56、23mg/L；p = 0.002），革兰氏阳性菌与革兰氏阴性菌败血症患儿的CRP水平无差异（43、51mg/L；p = 0.37），早产死亡与存活患儿的CRP水平也无差异（38、28mg/L；p = 0.37）。
在患有EOS的新生儿中，CRP的使用因中心而异。CRP水平在时间、新生儿特征、病原体或死亡情况方面无差异。
ClinicalTrials.gov标识符 早发型败血症一项NICHD/CDC监测研究（EOSII）：NCT02410486
