{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:57:52Z","timestamp":1781243872489,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Investigation"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>C\u2010reactive protein (CRP) is a commonly used biomarker for sepsis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate CRP's diagnostic performance to detect neonatal early\u2010onset sepsis (EOS), while accounting for both gestational and postnatal age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter retrospective study of neonates born from January 2006 to December 2017 in public hospitals in Hong Kong. Neonates who had CRP tested within 72 h of birth, prior to antibiotics initiation, were included. CRP values were analyzed by gestational age and time after birth. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curves, sensitivity, specificity, predictive values, and likelihood ratios (LRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 100 327 tested neonates, 448 developed culture\u2010confirmed EOS, and 34 had meningitis. In uninfected neonates, CRP concentrations rose naturally after 8 h of life, peaking at 24\u201332 h, with higher values in term neonates at 24\u201348 h (median 6.2 mg\/L, interquartile range 2.9\u201314.3). Diagnostic performance was better in preterm neonates (e.g., the area under the ROC curve after 4 h of life: 0.88 in &lt;34 weeks, 0.83\u20130.92 in 34\u201336 weeks, and 0.73\u20130.77 in term neonates). Sensitivity within the first 4 h was low across all groups. LRs increased with higher CRP values in preterm neonates. A CRP\u00a0value of &gt;12.0 mg\/L was associated with increased risk of meningitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>CRP is not recommended for EOS screening in term neonates, but it may be considered for assessing the risk of EOS in preterm neonates. Interpretation must account for gestational and postnatal age.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ped4.70025","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T07:16:53Z","timestamp":1761290213000},"page":"337-346","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The utility of C\u2010reactive protein in neonatal early\u2010onset sepsis screening: A territory\u2010wide cohort analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6613-7366","authenticated-orcid":false,"given":"Xuelian","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neonatology, Guangzhou Women and Children's Medical Center Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health  Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoi Ying Sharon","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiu Ying Peggy","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"},{"name":"Brain and Mind Institute The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po Gee Genevieve","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh Simon","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"},{"name":"Brain and Mind Institute The Chinese University of Hong Kong  Hong Kong China"},{"name":"Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.14889"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102393\u201012\u201048"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild\u20102018\u2010316777"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016\u20102845"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11195837"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000157"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa876"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000497237"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2011.02.020"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/47.6.1016"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/48.7.1103"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2020.1856068"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0009\u20108981(85)90218\u20109"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics10100839"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022\u20103476(82)80080\u20102"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2021.1888921"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02009664"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00972"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000512523"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/jmf.14.2.85.90"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005\u20101132"},{"key":"e_1_2_7_23_1","unstructured":"National Institute for Health and Care Excellence.Neonatal infection: antibiotics for prevention and treatment. 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