C-Reactive Protein in Early Diagnosis of Neonatal Late-Onset Sepsis: A Systematic Review and Meta-analysis

Author(s):

Abdulrahman Aldayel, Arkan Hamed Alshammari, Manal Taher Hakami, Tareq Hamad Alotaibi, Alaa Adel Alminee, Banan Sabri Alhijji, Abdullah Hamoud AlGharbi, Amjad Salem Alshammery, Rawabi Mousa Alqasem, Omran Saed Alharbi and Ali Abdurhman Aljallal

Background: C-reactive protein (CRP) is an acute-phase protein reactant that rises especially in response to infectious processes in adults and neonates. It has been used for decades as a tremendous indicator of sepsis in Neonatal in-depth Care devices (NICUs). Aim: This work aims to determine the accuracy of C - reactive protein (CRP), in early diagnosis of late-onset sepsis in infants. Materials and Methods: A systematic search was performed over different medical databases to identify Pediatrics studies, which studied the outcome of CRP in early diagnosis of late-onset sepsis (LOS) in infants. Using the meta-analysis process, either with fixed or random-effects models, we conducted a meta-analysis on sensitivity as a primary outcome, and on specificity as a secondary outcome. Results: Six studies were identified involving 1203 infants. The meta-analysis process revealed that the pooled sensitivity of CRP for diagnosis of late-onset infection=71.7% (p<0.001), and the pooled specificity of CRP for diagnosis of late-onset infection=76.1% (p<0.001). Conclusion: To conclude, late-onset sepsis represents significant morbidity and mortality in the neonatal intensive care unit, CRP plays an important role in the diagnosis of LOS.