Role of CSF-CRP as a Diagnostic Marker in Neonatal Meningitis

Abstract Background: Cerebrospinal fluid C-reactive protein (CSF-CRP) in adults and children has been shown to be useful for the diagnosis of bacterial meningitis; however, it has not been evaluated in neonates. Objective: To study the role of CSF-CRP as a diagnostic marker in neonatal meningitis and determine optimal cut-offs for diagnosis. Study Design: Prospective observational study from June 2017 to December 2017. Methodology: Routine CSF analysis along with CSF-CRP was performed in neonates who qualified for lumbar puncture. Results: At a cut-off value of 3.8 mg/L, CSF-CRP had a sensitivity of 0.96 and a specificity of 0.44, with positive and negative predictive values of 0.63 and 0.91, respectively. Conclusion: CSF-CRP has higher diagnostic efficiency than other CSF markers. At a value of 3.8 mg/L, it has a high sensitivity and a negative predictive value to rule out meningitis.

[1]  Malvika Kumar,et al.  Study of CSF C-reactive protein in meningitis to differentiate bacterial meningitis from aseptic meningitis in children between 1 month and 12 years of age , 2017 .

[2]  S. Korones,et al.  Committee on Fetus and Newborn , 2017, Pediatric Clinical Practice Guidelines & Policies.

[3]  K. Malla,et al.  Is Cerebrospinal Fluid C-reactive Protein a Better Tool than Blood C-reactive Protein in Laboratory Diagnosis of Meningitis in Children? , 2013, Sultan Qaboos University medical journal.

[4]  A. Hamedi,et al.  Evaluation of IL-6 and High Sensitive C Reactive Protein Value in CSF and Serum Children Suspected Meningitis Referred to Pediatric Emergency Room , 2012, Iranian Red Crescent medical journal.

[5]  K. Edwards,et al.  Long-term Outcomes of Group B Streptococcal Meningitis , 2012, Pediatrics.

[6]  R. Polin.  Management of Neonates With Suspected or Proven Early-Onset Bacterial Sepsis , 2012, Pediatrics.

[7]  B. Resch,et al.  An Update on the Use of C-Reactive Protein in Early-Onset Neonatal Sepsis: Current Insights and New Tasks , 2012, Neonatology.

[8]  J. Lawn,et al.  Long-term neurodevelopmental outcomes after intrauterine and neonatal insults: a systematic review , 2012, The Lancet.

[9]  M. Shalini,et al.  Cerebrospinal fluid C reactive protein and adenosine deaminase in meningitis in adults. , 2011, The Journal of the Association of Physicians of India.

[10]  V. Krebs,et al.  Clinical outcome of neonatal bacterial meningitis according to birth weight. , 2007, Arquivos de neuro-psiquiatria.

[11]  D. Harvey,et al.  Effect of meningitis in infancy on school-leaving examination results , 2007, Archives of Disease in Childhood.

[12]  V. Fowler,et al.  Neonatal Meningitis: What Is the Correlation Among Cerebrospinal Fluid Cultures, Blood Cultures, and Cerebrospinal Fluid Parameters? , 2006, Pediatrics.

[13]  Jalgaonkar Sv,et al.  Bacteriological study of pyogenic meningitis with special reference to C-reactive protein. , 2001 .

[14]  R. Khadse,et al.  Bacteriological study of pyogenic meningitis with special reference to C-reactive protein. , 2001, Indian journal of medical microbiology.

[15]  U. Singh.  Cerebrospinal fluid C-reactive protein in the diagnosis of meningitis in children. , 1994, Indian Pediatrics.

[16]  V. Kolb‐Bachofen.  A review on the biological properties of C-reactive protein. , 1991, Immunobiology.

[17]  S. Merchant,et al.  Use of CSF C-reactive protein in differentiating bacterial and non-bacterial meningitis. , 1987, Journal of postgraduate medicine.

[18]  A. Malaviya,et al.  C-reactive protein in clinical practice. , 1985, Indian pediatrics.

[19]  E. Moxon,et al.  C-reactive protein in spinal fluid of children with meningitis. , 1981, The Journal of pediatrics.

[20]  U. Carcassi,et al.  [C-reactive protein in clinical practice]. , 1957, Minerva medica.

[21]  Thomas Francis,et al.  SEROLOGICAL REACTIONS IN PNEUMONIA WITH A NON-PROTEIN SOMATIC FRACTION OF PNEUMOCOCCUS , 1930, The Journal of experimental medicine.