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BACKGROUND The aim of this study was to evaluate the diagnostic value of C-reactive protein (CRP) test in detecting neonatal septicemia. MATERIAL AND METHODS We searched the Cochrane Library, PubMed, Springer, MBASE, Elsevier Science Direct, and Medline databases up to March 2017. To collect relevant data on CRP testing in patients with neonatal septicemia, we performed a meta-analysis of positive likelihood ratio (LR), sensitivity, negative LR, specificity and diagnostic odds ratio (dOR) of CRP testing, using Stata 12.0 and Meta-DiSc 1.4 data analysis software. RESULTS Ten studies including 1819 participants were considered in this study. We found that positive LR, sensitivity, negative LR, specificity, and dOR of the CRP test for neonatal septicemia were 5.63 (95% CI=2.86 to 11.09), 0.70 (95% CI=0.66 to 0.75), 0.36 (95% CI=0.21 to 0.60), 0.89 (95% CI=0.87 to 0.91), and 17.99 (95% CI=6.50 to 49.83), respectively. The AUC and Q* index of this meta-analysis were 0.90 and 0.83, respectively. CONCLUSIONS The area under the curve (AUC), negative LR, positive LR, Q* index, specificity, and dOR of the CRP test suggest that it is appropriate for detecting neonatal septicemia.

This RCT provided valuable insights as to whether CRP-guided prescribing could safely reduce antibiotic use during acute COPD exacerbations.

The diagnosis of periprosthetic joint infection (PJI) can be challenging and rests on several principles. The use of diagnostic biomarkers, such as the synovial C-Reactive Protein (CRP), seems promising. The purpose of this study was to determine whether synovial CRP was a more discriminating test than serum CRP for the diagnosis of hip and knee PJI.In total, 194 patients were included in this single center prospective study: 42 primary arthroplasties (control group [CG]), 111 revisions for aseptic prosthesis (aseptic revision group [ARG]), and 41 revisions for septic prosthesis (septic revision group [SRG]) based on the Musculoskeletal Infection Society (MSIS) criteria.The serum and synovial CRP levels were significantly higher in the SRG than the other two groups (SRG serum CRP=75.6mg/L vs. ARG serum CRP=6mg/L and CG serum CRP=2.7mg/L, p0.001; SRG synovial CRP=31.5mg/L vs. CG synovial CRP=2.6mg/L and ARG synovial CRP=1.7mg/L, p0.001). The positive likelihood ratios (LR+) were very similar for both the synovial CRP cut-off value of 4.4mg/L (LR+=7.04; sensitivity [Se] 82.5%, specificity [Sp] 88.3%) and the serum CRP cut-off value of 9mg/L (LR+=6.3; Se 87.5%, Sp 86.1%).This study showed that synovial CRP testing was not more discriminating than serum CRP in the diagnosis of hip and knee PJI. A serum CRP level greater than 9mg/L was a sign of PJI.III; case-control study.

Background: C-reactive protein test is one of clinical assessments to minimize risks of infection in infants. However, its procedure may cause pain. Pain in the infant may result in negative metabolic behavior, physiology and metabolic response. Objective: This study was to describe the infant's pain response by administering a combination of breastfeeding and an effleurage massage on the blood sampling procedure of C-reactive protein examination. Methods: This was a descriptive observational cross-sectional study. There were 30 infants selected using consecutive sampling technique, which 15 samples assigned in an intervention group (combination of breastfeeding and effleurage massage) and a control group. Premature Infant Pain Profile (PIPP) instrument was used to measure pain. Univariate analysis was performed with the aim to describe data in mean and median.Results: The average of pain response at 1-minute observation in the combination of breastfeeding and effleurage massage group was 7.47 ± 1.356, and the average of pain response in the control group was 10.80 ± 1.897. The average pain at 5-minutes in the intervention group was 3.53 ± 1.922 and control group was 6.00 ± 1.852. Conclusions: Pain responses in the combination of breastfeeding and effleurage massage group were lower than the pain response in the control group.

L’ostéomyélite aiguë hématogène et l’arthrite septique aiguë ne sont pas rares chez les enfants, et il faut les envisager dans le cadre du diagnostic différentiel de douleurs aux membres et de pseudoparalysie. Chez les enfants, la plupart des infections osseuses sont causées par l’inoculation hématogène de bactéries dans les os. Le Staphylococcus aureus et le Kingella kingae sont les agents pathogènes les plus courants. Un chirurgien orthopédiste doit évaluer rapidement les enfants atteints d’arthrite septique pour l’aspiration et le débridement éventuel d’une ostéomyélite concomitante. Le traitement empirique optimal après des mises en culture appropriées continue d’être la céfazoline par voie intraveineuse. Dans la plupart des cas, il faut passer aux antimicrobiens par voie orale lorsque l’état clinique du patient s’est amélioré et que les marqueurs inflammatoires ont diminué. Dans la majorité des cas d’ostéomyélite sans complication, les recommandations actuelles consistent à administrer un traitement antimicrobien pendant trois à quatre semaines plutôt que pendant les six semaines préconisées auparavant.

Qualitative tests for C-reactive protein (CRP) are available for use in dogs, and provide a rapid in-house method of detecting acute inflammation. The aim of this study was to compare results from a qualitative CRP lateral flow test (Teco CRP FASTest) to those obtained from a quantitative CRP ELISA and to traditional methods of detecting inflammation, including total leukocyte and neutrophil numbers, presence of immature neutrophils and a left shift, presence or absence of toxic changes in neutrophils and plasma fibrinogen concentration in whole blood and serum samples collected from 113 client-owned dogs. More dogs had CRP FASTest positive results than had quantitatively increased CRP (ELISA) or increases in traditional methods used for measuring inflammation. Few dogs had increases in markers of inflammation but no elevated CRP. The qualitative CRP FASTest was found to be a sensitive test for detecting increased CRP concentration and was positive more frequently than were traditional markers of inflammation.

Available tests to diagnose infection in neonates often provide results after 12-24 hours. A bedside test that is reliable will facilitate earlier exclusion or diagnosis of infection.To validate a bedside C-reactive protein (CRP) test against the currently available laboratory CRP test in neonates with suspected sepsis.This was a prospective observational study where a bedside CRP was done concurrently with and validated against a laboratory CRP in neonates with suspected sepsis. The sensitivities, specificities and predictive values for the bedside CRP tests were calculated using the laboratory CRPs as the reference test.There were 209 measured CRP-sample pairs. Seventy per cent of these had suspected early-onset neonatal sepsis and 30% had suspected late-onset neonatal sepsis. Twelve per cent had culture-proven sepsis. At the recommended cut-off of 8.0 mg/L for the bedside CRP test, the sensitivity, specificity, positive and negative predictive values were 84%, 80%, 30% and 97%, respectively. Adjusting the cut-off value from 8.0 to 15.0 mg/L improved the specificity to 88%. The sensitivity, specificity and positive and negative predictive values were not different between early-onset and late-onset sepsis. The receiver operating characteristic curve had an area below the curve of 0.84 for the cut-off at 16.2 mg/L on the beside CRP test.The bedside CRP test may be used as a screening test to aid decisions to either commence or discontinue antibiotics in circumstances where the clinical diagnosis of sepsis is in doubt. By using a cut-off of 16.0 mg/L for the bedside CRP test, the possibility of a false negative result is minimised.

Objective To examine the effect of an education campaign based around a gold coin fine on ordering of C-reactive protein (CRP) tests. Design and setting A retrospective analysis of CRP test ordering before and after the intervention in the emergency department (ED) of a tertiary referral hospital in metropolitan Sydney that sees about 60,000 patients per annum. The date of the intervention - 2 August 2013 - corresponded with Jeans for Genes Day. Main outcome measures Number of CRP tests ordered in the ED. Results 1290 CRP tests were ordered before the intervention (1-31 July), and 394 were ordered after the intervention (2-31 August). This decrease in CRP test ordering was despite an increased number of ED presentations in August compared with July (5219 v 5497 presentations). This represented an absolute reduction in the rate of CRP test ordering of 17.6% (95% CI, 16.2%-18.9%; P Conclusion The threat of a gold coin fine for ordering a CRP test, as part of a broader education campaign, significantly reduced the number of CRP tests ordered in a tertiary referral ED.

C-reactive protein (CRP) values are clinically useful in differentiating viral from bacterial illnesses in children, but the regular test is impractical in the emergency department (ED) setting.To investigate the validity and feasibility of the 2-min bedside Quick Read (QR)-CRP test in the prediction of bacterial pneumonia in children in the ED.Fifty randomly selected children aged 4 days to 17 years, who presented to a pediatric ED with symptoms and signs of pneumonia over a 6-month period, were prospectively studied. The diagnosis of bacterial/viral pneumonia was based on clinical and radiological findings. CRP was measured in leftover blood (0.2 ml) using the QR-CRP kit. Clinical and laboratory data were statistically analyzed against CRP values for ability to predict bacterial pneumonia.Thirty-six patients (72%) were diagnosed with bacterial pneumonia and 14 (28%) with viral pneumonia; mean CRP levels were 121.3+/-122 and 27.2+/-26 mg/l, respectively (P=0.007). Significantly higher CRP levels were associated with bacterial than with viral pneumonia in the patients who presented before 96 h of symptom onset (P=0.013-0.028), but not in those who presented later. On receiver operating characteristics analysis, CRP was a better indicator of a chest radiograph picture of bacterial pneumonia (area under the curve=0.79) than absolute neutrophil count (0.78) or white blood cell count (0.73). Combining all three parameters yielded an area of 0.865.The QR-CRP test seems to be an useful predictor of bacterial pneumonia in children, especially those with a shorter illness duration, and is feasible for use in the ED.

Testing patients for bacterial infections during GP appointments could reduce unnecessary prescriptions of antibiotics, a systematic review published by the Cochrane Library has concluded.1 Most patients who visit their GP with acute respiratory infections have a viral infection, against which antibiotics are useless. Testing kits have been developed to quickly identify whether an infection is bacterial or viral. Currently the only one available to GPs is the C reactive protein test. The test takes about three minutes …

Background C-reactive protein (CRP) is widely used to detect bacterial infection in children. We investigated the impact of CRP test results on decision-making and summarized the evidence base (EB) of CRP testing. Methods We collected information from the hospital records of 91 neonates with suspected sepsis and of 152 febrile children with suspected infection on the number of ordered CRP tests, the number of EB-CRP tests, and the impact of the test results on decision-making. CRP diagnostic accuracy studies focusing on pediatric infections were reviewed critically. The main outcomes were the proportion of CRP tests that were EB and the proportion of tests that affected decision-making. A secondary outcome was the overall one-year expenditure on CRP testing. Results The current EB for CRP testing in pediatric infections is weak and suggests that CRP is of low diagnostic value. Approximately 54.8% of tests performed for suspected neonatal sepsis and 28% of tests performed for other infections were EB; however, the results of only 12.9% of neonatal sepsis tests and of 29.9% of tests on children with other infections informed decision-making. The one-year overall cost for CRP testing and related health care was $26,715.9. Conclusions The routine ordering of CRP for children with infections is based on weak evidence. The impact of the CRP test results on decision-making is rather small, and CRP ordering may contribute to unnecessary health care expenditures. Better quality research is needed to definitively determine the diagnostic accuracy of CRP levels in children with infections.

Serial tests for serum C-reactive protein (CRP) were carried out on 40 children undergoing cerebrospinal fluid shunt surgery, to determine the pattern of appearance and disappearance of CRP in relation to this type of operation, in the absence of postoperative complications. Samples of sera from a further 268 children, 79 of whom presented after shunt surgery with symptoms suggesting infective complications related to the shunt, were examined for CRP. The results showed that, while the test in negative in uncomplicated colonisation of ventriculo-atrial shunts, it is reliably positive in patients with colonised ventriculo-peritoneal shunts, ventriculitis, or shunt nephritis.

• The C-reactive protein test, performed by a capillary precipitin method with the use of commercially available antiserum, was applied to 3,543 blood donors and 633 patients in 37 different disease categories. The distribution of positive reactions failed to reveal any possibilities of the test as a screening method for the detection of any one condition in mass surveys. It was not of value in detecting carriers of homologous serum jaundice or in predicting minor transfusion reactions. Patients who experienced chills after transfusions developed a positive C-reactive protein test. Serums initially negative became positive after refrigeration and storage. The test represents a type of immune reaction but is unstable and nonspecific.

Results of C.R.P. test evaluation as an index of disease activity are reported in 10 cases of acute rheumatic fever, 18 cases of rheumatic heart disease and three cases, of rheumatic chorea. C.R.P. test seems to be a sensitive index of disease activity and a reliable guide to the management of cases. It faithfully reflects the activity and is not affected by drugs, a distinct advantage over E.S.R. However, being non-specific, it is not very helpful in diagnosis.

Introduction In response to a variety of inflammatory lesions, there appears in the blood of humans a protein substance not normally present, which is identified by its capacity to form a precipitate with the somatic Cpolysaccharide of the pneumococcus. 1 It has consequently been named C-reactive protein (CRP). Present knowledge points toward C-reactive protein being a β-globulin, probably bound to a lipid. Minute amounts of this protein may be demonstrated in human serum by a precipitin test employing a specific antiserum obtained from rabbits hyperimmunized by repeated injections of a purified C-reaction protein. In previous studies it has been demonstrated that the appearance of C-reactive protein in the blood is a nonspecific but extremely sensitive indicator of an inflammatory reaction due to infection. It has also been found in other disease processes of a noninfectious nature, such as malignancy and myocardial infarction. Kroop and Shackman 2 reported negative tests in

There are situations in which it is important to the physician to know whether or not his patient has an inflammatory or tissue-destroying process. Time-honored aids to the solution of this problem have been the patient's temperature, leucocyte count, and erythrocyte sedimentation rate. Recently the detection of the C-reactive protein in human blood has been gaining attention as an index to inflammation or tissue destruction within the body. This procedure has been used especially for the determination of activity in rheumatic fever.* It has been shown that it is a sensitive guide to rheumatic inflammation, that it disappears after suppression of clinical signs and symptoms of activity with either salicylates or steroid therapy, and that it reappears if there is a clinical relapse. The times of disappearance and reappearance ordinarily precede the corresponding change in the erythrocyte sedimentation rate. The C-reactive protein has not been reported in the serum of