Use and utility of C-reactive protein (CRP) in neonatal early-onset sepsis: a secondary analysis of a prospective surveillance study

Characterize C-reactive protein (CRP) within 72 postnatal hours in early-onset sepsis (EOS).

Secondary analysis of a prospective surveillance study of neonates with EOS 2015–2017. We examined CRP use by center and neonatal characteristics, and CRP levels by time, neonatal characteristics, clinical signs, and pathogen.

CRP was obtained for 96/235 neonates with EOS, which varied by center (p < 0.001). 71/95 had CRP > 10 mg/L (1 missing). Neonatal characteristics with and without CRP did not differ. There was no relationship between CRP level and timing (p = 0.41) or neonate characteristics. Median CRP was higher with ≥5 vs <5 clinical signs (56, 23 mg/L; p = 0.002), and was not different in Gram-positive vs Gram-negative sepsis (43, 51 mg/L; p = 0.37) or preterm neonates who died vs survived (38, 28 mg/L; p = 0.37).

Among neonates with EOS, CRP use varied by center. CRP levels did not differ by time, neonate characteristics, pathogen, or death.

ClinicalTrials.gov ID Early-Onset Sepsis an NICHD/CDC Surveillance Study (EOSII): NCT02410486.