ArticleThe Journal of pediatrics2023
Diagnostic Performance and Patient Outcomes With C-Reactive Protein Use in Early-Onset Sepsis Evaluations.
Article in The Journal of pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 30 citations in OpenAlex.
- Reducing unnecessary antibiotic exposure among neonates evaluated for suspected early-onset sepsis through an adapted risk-stratification and antimicrobial stewardship pathway in northwest Ethiopia: a prospective quality improvement study.BMJ paediatrics open · 2026Article
- Article
- Comparing early-onset sepsis risk: risk calculator, American Academy of Pediatrics guidelines, and local care.Pediatric research · 2026Article
- Restricting C-Reactive Protein Use in Early-Onset Neonatal Sepsis Reduces Unnecessary Antibiotic Exposure.Antibiotics (Basel, Switzerland) · 2026Article
- Sepsis biomarkers: recent advances and future perspectives.Frontiers in immunology · 2026Review
- Article
- Prevalence and overlap of white blood cell counts, procalcitonin and C-reactive protein in neonates with invasive bacterial infections.Translational pediatrics · 2025Article
- Comparison of the accuracy of hematological parameters in the diagnosis of neonatal sepsis: a network meta-analysis.Infection · 2025Article
- Understanding variation in management of early-onset neonatal sepsis in India: a vignette-based survey.BMJ paediatrics open · 2025Article
- Plasma Bile Acid Profiling Reveals Novel Early Diagnostic Biomarkers for Pediatric Sepsis.Journal of inflammation research · 2025Article
- Use and utility of C-reactive protein (CRP) in neonatal early-onset sepsis: a secondary analysis of a prospective surveillance study.Journal of perinatology : official journal of the California Perinatal Association · 2025Observational
- Clinical and economic impacts of a modified-observational screening approach to well-appearing infants born to mothers with chorioamnionitis.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Incidence of Antibiotic Exposure for Suspected and Proven Neonatal Early-Onset Sepsis between 2019 and 2021: A Retrospective, Multicentre Study.Antibiotics (Basel, Switzerland) · 2024Article
- Sustaining the Continued Effectiveness of an Antimicrobial Stewardship Program in Preterm Infants.Tropical medicine and infectious disease · 2024Article
- [Construction of a back propagation neural network model for predicting urosepsis after flexible ureteroscopic lithotripsy].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2024Article
- Immunotherapy in the context of sepsis-induced immunological dysregulation.Frontiers in immunology · 2024Review
- Effects of C-reactive protein trajectories of critically ill patients with sepsis on in-hospital mortality rate.Scientific reports · 2023Review
- Clinical Utility of the FilmArrayMicroorganisms · 2023Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesTo determine performance of C-reactive protein (CRP) in the diagnosis of early-onset sepsis, and to assess patient outcomes with and without routine use of CRP. STUDY
designThis was a retrospective cohort study of infants admitted to 2 neonatal intensive care units. CRP was used routinely in early-onset sepsis evaluations during 2009-2014; this period was used to determine CRP performance at a cut-off of ≥10 mg/L in diagnosis of culture-confirmed early-onset sepsis. Routine CRP use was discontinued during 2018-2020; outcomes among infants admitted during this period were compared with those in 2012-2014.
resultsFrom 2009 to 2014, 10 134 infants were admitted; 9103 (89.8%) had CRP and 7549 (74.5%) had blood culture obtained within 3 days of birth. CRP obtained ±4 hours from blood culture had a sensitivity of 41.7%, specificity 89.9%, and positive likelihood ratio 4.12 in diagnosis of early-onset sepsis. When obtained 24-72 hours after blood culture, sensitivity of CRP increased (89.5%), but specificity (55.7%) and positive likelihood ratio (2.02) decreased. Comparing the periods with (n = 4977) and without (n = 5135) routine use of CRP, we observed lower rates of early-onset sepsis evaluation (74.5% vs 50.5%), antibiotic initiation (65.0% vs 50.8%), and antibiotic prolongation in the absence of early-onset sepsis (17.3% vs 7.2%) in the later period. Rate and timing of early-onset sepsis detection, transfer to a greater level of care, and in-hospital mortality were not different between periods.
conclusionsCRP diagnostic performance was not sufficient to guide decision-making in early-onset sepsis. Discontinuation of routine CRP use was not associated with differences in patient outcomes despite lower rates of antibiotic administration.
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