Abstract

CHANDRAMATI, J  and  PONTHENKANDATH, S. The cost-effectiveness and value of C-reactive protein in the diagnosis and management of neonatal late-onset sepsis in resource-limited settings. S. Afr. j. child health [online]. 2023, vol.17, n.1, pp.1-4. ISSN 1999-7671.  http://dx.doi.org/10.7196/SAJCH.2023.V17I1.1899.

BACKGROUND: Although C-reactive protein (CRP) is used as a biomarker, its value in resource-limited settings for diagnosis and management of late-onset sepsis in neonates has not been reported previously OBJECTIVE: To evaluate the value of CRP as a biomarker in identifying late-onset sepsis in symptomatic infants METHOD: We performed a retrospective study to evaluate the value of CRP as a biomarker in identifying late-onset sepsis in symptomatic infants. Infants were classified into three groups (blood culture-proven sepsis (n=72), clinical sepsis (n=38) and no sepsis (n=114)). Infants underwent sepsis work-up consisting of complete blood count (CBC), blood culture, urine and cerebrospinal fluid (CSF) culture including CRP measurements RESULTS: The overall sensitivity and specificity of CRP levels >10 |ig/mL was 94.5% and 91.2%, respectively, for the diagnosis of late-onset sepsis. Positive predictive value was 91.2% and negative predictive value was 92.8%. Total white blood cell (WBC) counts had poor sensitivity and specificity compared with CRP. The cost for CRP testing was only 2.5% of the total cost for sepsis work-up in neonates CONCLUSION: Our study indicates that CRP has excellent sensitivity and specificity in the diagnosis of late-onset sepsis. In low- and middle-income countries, CRP testing perhaps offers more value compared with W14BC counts

Keywords : CRP; late-onset sepsis; neonates; cost-effectiveness; value.

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