Usefulness Of Estimation Of CRP With Technologically Better Method Called High Sensitivity C-Reactive Protein (Hs CRP) Estimation, In The Spectrum Of Infection, Ranging From Infection To Septic Shock.
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 4775-4781
AbstractAim: The present study is carried to ascertain usefulness of estimation of CRP with technologically better method called High Sensitivity C-Reactive Protein (Hs CRP) estimation, in the spectrum of infection, ranging from infection to septic shock. The age group included is from birth to 2 months of age. An effort has been made to correlate values of Hs CRP with respect to severity of infection.
Material and methods: This prospective observational study was carried out in the Department of Pediatrics, Anugrah Narayan Magadh Medical College and Hospital Gaya, Bihar, India for 1 year. Each paediatric patient who came to our Hospital was initially categorized according to age till 2 months of age. Neonates were graded according to the signs and symptoms of FIMNCI. FIMNCI considers bacterial infections in young infants when signs or symptoms of sepsis, pneumonia or meningitis are present. 2 ml of blood was again collected from the corresponding patient in a plain bulb under all aseptic precautions. The sample was then sent laboratory for CRP testing.
Results: Out of 80, 70 cases were successfully followed up to 48 hours as was aimed at the beginning of the study and 10 cases failed to complete a 48 hour study period due to various reasons. Out of 70 newborns studied, 45 were male and 25 were female babies. Clinical improvement was assessed by hemodynamic profile, absence of presenting complaint/s and ability to tolerate feed and absence of blood culture positivity of first culture. 20 babies improved clinically, whereas 27 babies had almost similar clinical profile. 23 babies showed clinical downward status in spite of starting empirical antibiotics and supportive treatment. Surprisingly, majority of babies had shown positivity in HS-CRP at admission (60/70) as well as after 48 hours (62/70).Mean and median of all babies as shown in Table 3 was not conclusive about severity of infection and CRP values. It seems that Hs CRP is very sensitive indicator for neonatal sepsis. Neonates were further categorised in 3 groups depending on clinical improvement and fall or rise of Hs CRP level was studied. It was seen that Hs CRP levels have decreased in group which had shown clinical improvement, however in both other groups it was showing rise.We have calculated independent t-value also for each group and it was seen that change in Hs CRP values after 48 hours was significant.
Conclusion: The study revealed that HS CRP levels were increased in all cases of suspected neonatal sepsis. They remained high in neonates who had deteriorated or remained same clinically at 48 hours of follow-up. However, they significantly reduced in neonates showing clinical improvement.
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