Hindocha P, Campbell C A, Gould J D, Wojciechowski A, Wood C B
J Clin Pathol. 1984 Sep;37(9):1014-7. doi: 10.1136/jcp.37.9.1014.
The usefulness of serial study of C reactive protein in the early detection of neonatal septicaemia was evaluated in a neonatal unit using a commercially available latex agglutination slide test as a rapid screening method and electroimmunoassay as a reference method for C reactive protein determination. A positive latex test was obtained in 11 infants with verified septicaemia (positive blood culture), two infants with clinically evident infection but without bacteriological confirmation, one infant with recurrent chest infection due to Pseudomonas aeruginosa, and one infant who showed signs of birth asphyxia with meconium aspiration, but was not infected. Positive latex test results correlated with raised concentrations of C reactive protein, measured by immunoassay. In some instances, however, concentrations of C reactive protein in excess of 12 mg/100 ml gave weaker agglutination results in the slide test, which could be interpreted as negative results. In a sequential study of the infected infants, 6.3% of the values recorded on a slide test were false negatives. In contrast, false positive values were observed on a slide test in 1.9% of 27 non-infected infants. The higher percentage of false negative values may be due to the presence of excess antigen in the sera of some infected children. It is suggested that the latex test should be carried out on suitable dilutions of serum. Although the slide test may reliably indicate infection at an early stage in neonates, the C reactive protein response is non-specific, as seen in a non-infected infant who showed signs of birth asphyxia with meconium aspiration. Provided the non-specific nature of the C reactive protein response is recognised, the latex test may be a useful serum measurement for early diagnosis of neonatal septicaemia of the newborn. The test has the advantage of being performed easily, quickly, and cheaply.
在一家新生儿病房中，使用市售乳胶凝集玻片试验作为快速筛查方法，并采用电免疫测定法作为测定C反应蛋白的参考方法，对C反应蛋白系列研究在新生儿败血症早期检测中的实用性进行了评估。11例经证实患有败血症（血培养阳性）的婴儿、2例临床有明显感染但未经细菌学证实的婴儿、1例因铜绿假单胞菌反复发生肺部感染的婴儿以及1例有出生窒息伴胎粪吸入体征但未感染的婴儿，乳胶试验呈阳性。乳胶试验阳性结果与免疫测定法测得的C反应蛋白浓度升高相关。然而，在某些情况下，C反应蛋白浓度超过12mg/100ml时，玻片试验中的凝集结果较弱，可能被解释为阴性结果。在对感染婴儿的连续研究中，玻片试验记录值中有6.3%为假阴性。相比之下，在27例未感染婴儿中，有1.9%的玻片试验出现假阳性值。假阴性值比例较高可能是由于一些感染儿童血清中存在过量抗原。建议对血清进行适当稀释后再进行乳胶试验。尽管玻片试验可能可靠地指示新生儿早期感染，但C反应蛋白反应是非特异性的，如1例有出生窒息伴胎粪吸入体征的未感染婴儿所示。只要认识到C反应蛋白反应的非特异性，乳胶试验可能是新生儿败血症早期诊断的一种有用的血清检测方法。该试验具有操作简便、快速且成本低廉的优点。
