CRP stays in high 30's all the time???????

[jacobsmum]

Im not a nurse, but saw this and thought I'd ask for advice or ideas.

I gave birth to a 25 weeker 5 weeks ago, weighing 1 pound 11. He has had some hurdles, i.e brain bleed and seizures but seems to be making some progress now. One thing is bothering me though. His CRP level has never dropped below 32. It does sometimes go higher but mostly stays around this mark. He has been treated for a staph infection twice and been on 3 anti-biotics at the same time. The infections seem to have gone, but the CRP stays at 32.

I often feel that there is an infection gone undetected that is waiting to lurch out each time anti-biotics are stopped.

Any ideas of what it could indicate?

I appreciate your suggestions

[NICU_Nurse, BSN, RN]

I don't know a whole lot about it, to be honest, and I'm sure that others will post here and/or correct me if I'm mistaken.

From what *I* understand, the CRP test can be given along with other blood tests (i.e, CBC's and blood cultures) to determine if the baby is experiencing either sepsis or meningitis. It is not, as far as I am aware, a reliable indicator all by itself; in other words, you would use this along with the CBC results (say, if they showed a marked increase in WBC's, which the body uses to fight infection, or if the CBC showed a consistent pattern of rise) and the blood cultures (when the blood is tested for growth for any number of organisms) to confirm a diagnosis of neonatal sepsis. I *do* know that sometimes CRP tests can show false positive results, so used by itself, it's not really reliable to determine if the baby has an infection.

I'd say that in addition to the CRP results, you should consider asking the doctors about the CBC and culture results and, if you feel that it's necessary, ask them to provide you with a daily update (or just simply ask them every day). Looking at all three types of tests will give you a more comprehensive idea of what's going on with his body. :)

[Mira]

I agree with the above answer.C-reactive protein is not a reliable indicator for infection alone,apart from positive cultures,raised wbc and etc.we need to look on the changes in vital signs,overall behavior of the baby,and color of the skin that indicates infection.Preemies usually have raised crp as a reaction to trauma,in the case of your baby,probably because of the resolving brain bleed.Your baby will always be prone to infection until his/her immune system develops fully.I hope all will be well.I wish you all the best.

[nurseiam]

From what I understand about CRP is that there needs to be a baseline. If the first one was in the thirtys and it was at the begining of the first infection it could just be the baseline and your looking for changes from the initial. In our unit they get an initial 72 hours, then if they might be septic we draw a crp with the other labs. But it is something that we never reley on.