Document Type : Original Article
Authors
- Mandana Kashaki 1
- Elahe Norouzi 2
- Saeideh Heidarali 3
- Parisa Mohagheghi 4
- Mahmoud Soltani 5
- Hamid Karbalaei Hasani Karbalaei Hasani 6
1 Assistant Professor of Neonatal-Perinatal Medicine, Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences, Tehran, Iran
2 Assistant Professor of Pediatrics, Neonatologist, Department of Pediatrics, Pediatric Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran
3 Pediatrician, Iran University of Medical Sciences, Tehran, Iran
4 Associate Professor of Pediatrics, Neonatologist, Department of Pediatrics, Pediatric Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran
5 Assistant Professor of Neonatal-Perinatal Medicine, Iran University of Medical Sciences, Tehran, Iran
6 Pediatrics Resident, Iran University of Medical Sciences, Tehran, Iran
Abstract
Background: Meningitis is a common life threatening infection in neonatal period. Diagnostic value of CSF-CRP level in bacterial meningitis in children and adults has been studied worldwide, but there are limited studies on CSF-CRP in neonatal meningitis. This study conducted to assess any relation between CSF-CRP and plasma CRP levels and abnormal CSF findings in neonates suspected to meningitis.
Methods: Seventy five hospitalized neonates suspected to meningitis were enrolled in this cross sectional study. All infants were gone through a complete sepsis workup including blood and CSF CRP.
Results: CSF-CRP level had statistically significant correlation with serum WBC (p= 0.048) and also poor correlation with CSF protein level (p= 0.054). Serum CRP level had statistically significant correlation with CSF WBC (p= 0.008).
Conclusion: No correlation found between CSF and serum CRP levels of patients in this study. Although, CSF-CRP is a rapid and easy to interpret test, it can be performed alongside CSF cytology and biochemical analysis, smear and culture as a confirmatory test for definite diagnosis of neonatal meningitis.
Keywords
- Ku LC, Boggess KA, Cohen-Wolkowiez M. Bacterial meningitis in infants. Clin Perinatol 2015; 42(1):29-45.
- Gaschignard J, Levy C, Romain O, Cohen R, Bingen E, Aujard Y, et al. Neonatal bacterial meningitis: 444 cases in 7 years. Pediatr Infect Dis J 2011; 30(3):212-7.
- Polin RA, Harris MC. Neonatal bacterial meningitis. Semin Neonatol 2001; 6(2):157-72.
- Franco SM, Cornelius VE, Andrews BF. Long-term outcome of neonatal meningitis. Am J Dis Child 1992; 146(5):567-71.
- Niknafs P; Norouzi E; Bahman Bijari B; Baneshi MR. Can we Replace Arterial Blood Gas Analysis by Pulse Oximetry in Neonates with Respiratory Distress Syndrome, who are Treated According to INSURE Protocol? IJMS 2015; 40(3): 264-7.
- Corrall CJ, Pepple JM, Moxon R, Hughes WT. C-Reactive protein in spinal fluid of children with meningitis. Journal of Pediatrics 1981; 99(3):365-9.
- Pepys MB. C-reactive protein-fifty years on. Lancet 1981; 1(8221):653-7.
- Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 1999; 340(6):448-54.
- Hofer N, Zacharias E, Muller W, Resch B. An update on the use of C-reactive protein in early-onset neonatal sepsis: current insights and new tasks. Neonatology 2012; 102(1):25-36.
- Javadinia S, Tabasi M, Naghdalipour M, Atefi N, Asgarian R, Khezerloo JK, et al. C-reactive protein of cerebrospinal fluid, as a sensitive approach for diagnosis of neonatal meningitis. Afri Health Sci 2019; 19(3):2372-7.
- Natani BS, Goyal P, Agarwal A, Bhatia S, Kumar M. 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. Int J Contemp Pediatr 2017; 4(3):943-6.
- Singh N, Arora S, Kahlon PS. Cerebrospinal fluid C- reactive protein in meningitis. Indian Pediatr 1995; 32:687-8.
- Prasad PL, Nair MN, Kalghatg AT. Childhood bacterial meningitis and usefulness of C-reactive protein. Med J Armed Forces India 2005; 61(1):13-15.
- Chandel R, Goyal S, Poswal L, Asif M. Diagnostic value of CSF C-reactive protein in meningitis: A prospective study. International Journal of Biomedical Research 2016; 7(6):387-390.
- Malla KK, Malla T, Rao KS, Basnet S, Shah R. Is cerebrospinal fluid C-reactive protein a better tool than blood C-reactive protein in laboratory diagnosis of meningitis in children? Sultan Qaboos Univ Med J 2013; 13(1):93-9.
- Jain S, Nayak R, Sharma A. Role of C- reactive proteins in cerebro-spinal fluid in differentiating pyogenic from nonpyogenic meningitis. International Journal of Research in Medical Sciences 2016; 4(7): 2839-42.
- Belagavi AC, Shalini M. Cerebrospinal fluid C reactive protein and adenosine deaminase in meningitis in adults. J Assoc Physicians India 2011; 59:557-60.
- Gedam DS. CRP, an acute phase reactant: role in Differentiating Bacterial and Non-Bacterial CNS Infections. Int J Med Res Rev 2013; 1(2):45-46.
- Komorowski RA, Farmer SG, Knox KK. Comparison of cerebrospinal fluid C-reactive protein and lactate for diagnosis of meningitis. J Clin Microbiol 1986; 24(6):982-5.
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