Pediatric Investigation最新文献

{"title":"Interaction analysis of non-bacterial respiratory pathogens during and after the coronavirus disease 2019 pandemic in two cities along the eastern coast of China.","authors":"Wanxian Ye, Jishan Zheng, Yungang Yang, Xinyue Song, Xiang Yuan, Lan Yang, Jian Yu, Hailin Zhang, Shunhang Wen","doi":"10.1002/ped4.70034","DOIUrl":"https://doi.org/10.1002/ped4.70034","url":null,"abstract":"<p><strong>Importance: </strong>The coronavirus disease 2019 (COVID-19) pandemic and associated non-pharmaceutical interventions (NPIs) have significantly altered the epidemiology of respiratory pathogens. Understanding the interactions between non-bacterial respiratory pathogens is crucial for clinical management and surveillance.</p><p><strong>Objective: </strong>To investigate how interactions among non-bacterial respiratory pathogens in children changed during and after the COVID-19 pandemic in two cities in eastern China.</p><p><strong>Methods: </strong>This retrospective study reviewed the data of children hospitalized with acute respiratory tract infections in Wenzhou and Ningbo between March 1, 2021, and February 28, 2024. The SureX 13 respiratory pathogen multiplex kit was used to detect 13 pathogen types/subtypes in the respiratory tract secretion specimens. The chi-square test or Fisher's exact test, virus correlation, and vector autoregressive modelling were employed to evaluate correlations and dynamic changes in the weekly positive detection rates before and after the NPIs.</p><p><strong>Results: </strong>Among the 73 096 children tested, 65.18% had at least one non-bacterial respiratory pathogen, and 11.97% had multiple pathogens. Detection rates declined significantly by 56.65% during NPIs but rebounded by 75.46% afterward, particularly for <i>Mycoplasma pneumoniae</i>, which increased from 5.29% to 34.78%. Post-pandemic, the co-detection of non-bacterial respiratory pathogens increased, with interaction patterns varying by phase. Notably, after the pandemic, the positive and negative correlations among pathogens intensified, with a significant increase in negative associations. Furthermore, a persistent negative correlation existed between the influenza B virus and <i>Mycoplasma pneumoniae</i> (-0.36 to -0.25), suggesting the potential presence of pathogen interference.</p><p><strong>Interpretation: </strong>The interactions between non-bacterial respiratory pathogens markedly changed after COVID-19, showing strengthened correlations, which were primarily negative in nature. These observations underscore the importance of the ongoing surveillance of respiratory pathogens in evolving NPIs and epidemiological patterns.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 1","pages":"47-59"},"PeriodicalIF":2.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic potential of tetrahydroxylated bile acids in reducing liver injury: Insights from the <i>Zfyve19^-/-</i> mouse model.","authors":"Li Wang, Yue Yu, Jiayan Feng, Yanan Zhang, Renxue Wang, Huiyu She, Teng Liu, Victor Ling, Jianshe Wang","doi":"10.1002/ped4.70036","DOIUrl":"https://doi.org/10.1002/ped4.70036","url":null,"abstract":"<p><strong>Importance: </strong>The production of tetrahydroxylated bile acids (THBAs) is associated with better prognosis in some cholestatic patients as well as in multidrug resistance protein 2 knockout (<i>Mdr2^-/-</i> ) mice. However, it remains unclear whether this protective effect is specific to <i>Mdr2^-/-</i> mice.</p><p><strong>Objective: </strong>To evaluate the effects of THBA (3α,6α,7α,12α-Tetrahydroxy-10β,13β-pentanoic acid) in <i>Zfyve19^-/-</i> mice, a newly developed mouse model characterized by cholestatic liver injury.</p><p><strong>Methods: </strong>THBA was administered to <i>Zfyve19^-/-</i> mice challenged with alpha-naphthyl isothiocyanate (ANIT). Serum biochemistry, liver histology and immunostaining, and quantitative PCR for hepatic expression of pro-fibrotic, pro-inflammatory, and bile acid metabolism-related genes were performed and compared against ANIT-treated wild-type and <i>Zfyve19^-/-</i> mice fed normal chow.</p><p><strong>Results: </strong>THBA administration reduced serum alanine aminotransferase (<i>P </i>< 0.001) and total bile acid levels (<i>P </i>< 0.001), decreased necrosis (<i>P</i> = 0.046), portal inflammation (<i>P </i>< 0.001), bile duct hyperplasia (<i>P</i> = 0.007), and portal fibrosis (<i>P</i> = 0.002) in liver histology, along with a significant reduction in hepatic expression of pro-fibrotic genes (<i>Acta2</i>, <i>Col1a1</i>, <i>Tgfb1</i>, <i>Tgfb2</i>, and <i>Timp1</i>), as well as the pro-inflammatory cytokines <i>Tnf</i> and macrophage chemokines (<i>Ccl2</i>, <i>Cxcl1</i>, <i>Cxcl9</i>, <i>Cxcl10</i>, and <i>Nos2</i>). Additionally, the mRNA expression of <i>Nr1h4</i> was profoundly upregulated, while key enzymes involved in bile acid synthesis were downregulated.</p><p><strong>Interpretation: </strong>THBA effectively alleviated cholestatic liver injury and fibrosis, and may represent a potential agent for the medical management of such diseases.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 1","pages":"60-69"},"PeriodicalIF":2.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next-generation sequencing in newborn screening: Current status, challenges, and future perspectives.","authors":"Zhelan Huang, Wenhao Zhou","doi":"10.1002/ped4.70030","DOIUrl":"https://doi.org/10.1002/ped4.70030","url":null,"abstract":"<p><p>Newborn screening (NBS) is a key public health intervention that improves children's health outcomes by enabling precise intervention through the early detection of hereditary and metabolic diseases. With advances in genomic technology, genomic NBS (gNBS) is gradually overcoming the limitations of conventional biochemical NBS and emerging as an innovative approach. This review systematically summarizes the developmental trajectory of NBS, highlighting the transformative transition from conventional biochemical methods to genetic approaches. It also presents global initiatives and preliminary findings from gNBS practices. Although gNBS offers broad potential applications, several critical challenges must be addressed to optimize its clinical implementation. Comprehensive international collaboration is essential for advancing gNBS and enhancing newborn health worldwide.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 1","pages":"70-85"},"PeriodicalIF":2.0,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the direct and indirect effects of interpersonal mindfulness on school-age bullying perpetration and victimization: The mediating role of emotional intelligence.","authors":"Marguerita Aoun, Elias Saade, Abdallah Chahine, Georges Maalouf, Abdo Hankache, Sahar Obeid, Feten Fekih-Romdhane, Souheil Hallit","doi":"10.1002/ped4.70031","DOIUrl":"https://doi.org/10.1002/ped4.70031","url":null,"abstract":"<p><strong>Importance: </strong>As interpersonal mindfulness is a relatively recently developed concept, there is limited research on how it relates to school-age bullying perpetration/victimization (BP/BV).</p><p><strong>Objective: </strong>To assess the direct and indirect effects of interpersonal mindfulness on school-age BP and victimization while focusing on the mediating role of emotional intelligence.</p><p><strong>Methods: </strong>Our study utilized a cross-sectional design between May and September 2024, and recruited 451 adolescents in schools aged between 12 and 18 years. Applying the snowball technique, a questionnaire was sent via Google Forms to the principal of each school, who redirected the questionnaire to the students after obtaining consent from their parents.</p><p><strong>Results: </strong>Emotional intelligence mediated the associations between interpersonal mindfulness and BV and BP. Higher interpersonal mindfulness was significantly associated with higher emotional intelligence. Higher emotional intelligence was significantly associated with lower BV and BP (<i>r</i> = -0.52, <i>P</i> < 0.001; <i>r</i> = -0.50, <i>P</i> < 0.001, respectively). Interpersonal mindfulness was directly associated with BP. However, no significant direct association was found with BV.</p><p><strong>Interpretation: </strong>Our results underscore the importance of promoting emotional intelligence as a core intermediate factor linking interpersonal mindfulness to bullying. Given that emotional intelligence can be regarded as a skill that can be trained, our findings can offer a potential target for prevention and intervention.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 2","pages":"171-181"},"PeriodicalIF":2.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic relationships between bilirubin concentrations and the gut microbiota in the neonatal period: A pilot prospective cohort study.","authors":"Zhongyuan Li, Yan Zhang, Xi Luo, Yangyang Wang, Lihua Peng, Liping Zou","doi":"10.1002/ped4.70032","DOIUrl":"10.1002/ped4.70032","url":null,"abstract":"<p><strong>Importance: </strong>Understanding the dynamic interplay between gut microbiota development and bilirubin metabolism may provide new insights into the pathophysiology of neonatal jaundice. Identifying microbial taxa associated with bilirubin fluctuations could help inform early prediction and microbiota-targeted interventions for hyperbilirubinemia.</p><p><strong>Objective: </strong>To investigate the correlation between dynamic changes in the gut microbiota and bilirubin concentrations during the neonatal period.</p><p><strong>Methods: </strong>Bilirubin concentrations were monitored daily throughout the neonatal period. Fecal samples were collected from neonates on days 1, 3, 7, 14, 21, and 28 after birth. The composition of the gut microbiome was assessed by 16S rRNA gene amplicon sequencing of the fecal samples. Within-subject, same-day associations between transcutaneous bilirubin (TcB) and genus-level abundance were quantified using a repeated-measures correlation.</p><p><strong>Results: </strong>Thirty neonates were included in the final analysis. Among the top-30 genera, six exhibited false discovery rate significant, same-day within-subject associations with TcB under the repeated-measures correlation framework (|r_rm| ≥0.30). Changes in the abundances of the genera <i>Streptococcus</i> (<i>r</i> _rm = +0.416, 95% confidence interval [CI] 0.272-0.543, <i>P</i> = 2.084 × 10^-7; <i>P</i>-adj = 3.126 × 10^-6) and <i>Rothia</i> (<i>r</i> _rm = +0.340, 95% CI 0.187-0.476; <i>P</i> = 3.134 × 10^-5; <i>P</i>-adj = 1.567 × 10^-4) were positively correlated with bilirubin concentrations throughout the neonatal period. In complementary cross-sectional analyses centered on meconium, additional genus-bilirubin correlations were identified for TcB measured on postnatal days 3-7 and for the neonatal TcB peak, with multiplicity controlled separately for each endpoint.</p><p><strong>Interpretation: </strong>A correlation was found between dynamic changes in the gut microbiome and bilirubin concentrations during the neonatal period. The identified genera might be potential markers or targets for intervention for neonatal jaundice.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 4","pages":"347-360"},"PeriodicalIF":2.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>CRPPA</i> exon 6-9 deletion as a founder mutation in Chinese patients with dystroglycanopathy.","authors":"Jihang Luo, Yidan Liu, Danyu Song, Shiqi Yang, Xiaona Fu, Lin Ge, Cuijie Wei, Liya Cui, Yanbin Fan, Huaxia Luo, Yanwei He, Jin Xu, Qiang Shen, Yuxuan Guo, Motoi Kanagawa, Tatsushi Toda, Jingmin Wang, Hong Zhang, Hui Xiong","doi":"10.1002/ped4.70029","DOIUrl":"https://doi.org/10.1002/ped4.70029","url":null,"abstract":"<p><strong>Importance: </strong>Dystroglycanopathies (DGPs) are a group of muscular dystrophies with abnormal glycosylation of dystroglycan. <i>CRPPA</i> is a gene associated with DGPs. Understanding the genetic basis, genotype-phenotype correlations, and population-specific mutations is crucial for accurate diagnosis and genetic counseling.</p><p><strong>Objective: </strong>To investigate <i>CRPPA</i> mutations in Chinese pediatric patients with DGPs, analyze genotype-phenotype correlations, and determine whether specific deletions represent founder mutations in this population.</p><p><strong>Methods: </strong>Clinical and genetic data of pediatric patients with <i>CRPPA</i>-related DGPs between June 2006 and December 2023 from Peking University First Hospital were collected and analyzed. Muscle biopsy specimens from four patients were examined using immunohistochemistry, immunofluorescence, and electron microscopy. Haplotype analysis was performed to investigate the potential founder mutation.</p><p><strong>Results: </strong>Among the 16 patients studied, phenotypes ranged from severe muscle-eye-brain disease to milder limb-girdle muscular dystrophy. Twenty-one pathogenic variants were identified, including five novel variants. A recurrent exon 6-9 deletion emerged as the second most frequent variant (25.0%, 4/16), with haplotype analysis supporting a founder mutation in Chinese patients. At follow-up, most patients remained non-ambulatory, and one patient died of respiratory failure.</p><p><strong>Interpretation: </strong>This study broadens the <i>CRPPA</i> mutational spectrum and identifies a founder mutation of exon 6-9 deletion in Chinese patients. These findings have important implications for population-specific screening, diagnosis, and genetic counseling.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 1","pages":"25-37"},"PeriodicalIF":2.0,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ketogenic diet alters microbiome-metabolome profiles to improve West syndrome therapy.","authors":"Gan Xie, Qian Zhou, Jianxiang Liao, Yuejie Zheng, Wenjian Wang, Kunling Shen","doi":"10.1002/ped4.70027","DOIUrl":"https://doi.org/10.1002/ped4.70027","url":null,"abstract":"<p><strong>Importance: </strong>The ketogenic diet (KD) is effective in managing epilepsy, particularly West syndrome (WS); however, the role of gut microbiome (GM) and metabolome in its efficacy remains unclear. Understanding these mechanisms could optimize the KD for WS treatment.</p><p><strong>Objective: </strong>To identify microbiome-metabolome signatures associated with KD efficacy in WS by analyzing changes in GM composition and metabolic pathways.</p><p><strong>Methods: </strong>Fecal samples were collected from WS patients (<i>n</i> = 16) and healthy children (<i>n</i> = 24). Metagenome and metabolome analyses were performed to assess GM composition and metabolic profiles.</p><p><strong>Results: </strong>WS patients showed GM imbalances compared to healthy children. Disease status contributed sufficiently to the GM. The abundance of <i>Bacteroides</i>, <i>Parabacteroides</i>, and <i>Faecalibacterium</i> was lower in WS (3.30% vs. 39.86%, <i>P</i>-adj = 0.140; 0.14% vs. 0.73%, <i>P</i>-adj = 0.023; 0.04% vs. 1.35%, <i>P</i>-adj = 0.018), whereas <i>Bifidobacterium</i> and <i>Escherichia</i> were higher (6.08% vs. 2.23%, <i>P</i>-adj = 0.140; 7.57% vs. 0.15%, <i>P</i>-adj < 0.001). After KD, <i>Parabacteroides</i> (particularly <i>P. distasonis</i>) and <i>Bacteroides</i> (particularly <i>B. fragilis</i>) increased (0.14% vs. 0.35%, <i>P</i>-adj = 0.034; 3.30% vs. 21.18%, <i>P</i>-adj = 0.380); <i>Bifidobacterium</i> (particularly <i>B. breve</i>) and <i>Escherichia</i> (particularly <i>E. coli</i>) decreased from 6.08% and 7.57% to 1.24% and 2.52%, respectively. Kyoto Encyclopedia of Genes and Genomes pathway analysis demonstrated that ATP-binding cassette (ABC) transporters, fatty acid biosynthesis, tyrosine metabolism, and other pathways were significantly altered in patients with WS, and these alterations were reversed following ketogenic diet (KD) consumption. The KD also altered intestinal metabolites. Integrative analysis of microbial features, gene functions, and metabolites revealed that <i>Bacteroides</i> species and <i>P. distasonis</i> were significantly associated with ABC transporters, alanine aspartate and glutamate metabolism, and negatively correlated with 3-sulfinoalanine, suggesting potential regulatory roles in metabolic pathways.</p><p><strong>Interpretation: </strong>KD induces significant shifts in GM composition and metabolic pathways, which may contribute to its therapeutic efficacy in WS. The restoration of <i>Bacteroides</i> and <i>Parabacteroides</i> dominance, alongside alterations in gene functions and neurotransmitter-related metabolites, suggests a potential mechanism for the antiepileptic effects of KD.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"10 1","pages":"10-24"},"PeriodicalIF":2.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious mononucleosis complicated with Kawasaki disease: Two case reports and literature review.","authors":"Mengjia Liu, Lingyun Guo, Qinjing Li, Dilara Dilmurat, Gang Liu, Zhengde Xie","doi":"10.1002/ped4.70026","DOIUrl":"10.1002/ped4.70026","url":null,"abstract":"<p><strong>Introduction: </strong>Infectious mononucleosis (IM) and Kawasaki disease (KD) can present with overlapping clinical features, occasionally complicating the differential diagnosis. Given the significant differences in their management, accurate distinction is critical. It is exceptionally rare for a single patient to simultaneously suffer from both IM and KD in clinical practice.</p><p><strong>Case presentation: </strong>We report two cases of children over five years of age who initially presented with clinical manifestations suggestive of IM and serological evidence consistent with primary Epstein-Barr virus (EBV) infection, supporting an initial diagnosis of IM. Subsequently, both patients developed clinical features meeting the diagnostic criteria for KD. The final diagnosis was co-occurrence of IM and KD.</p><p><strong>Conclusion: </strong>We describe two cases of concurrent IM and KD, offering further insight into a possible association between primary EBV infection and KD. Clinicians should be mindful of the potential co-occurrence of these disorders, strive to avoid conflicts in treatment strategies, and take proactive measures to prevent complications.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 4","pages":"410-414"},"PeriodicalIF":2.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Nurses' perceptions about neonatal intensive care units providing family-centered care are associated with skin-to-skin contact implementation\".","authors":"","doi":"10.1002/ped4.70020","DOIUrl":"10.1002/ped4.70020","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1002/ped4.12402.].</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 4","pages":"415-416"},"PeriodicalIF":2.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The utility of C-reactive protein in neonatal early-onset sepsis screening: A territory-wide cohort analysis.","authors":"Xuelian Wang, Hoi Ying Sharon Lau, Hiu Ying Peggy Chan, Po Gee Genevieve Fung, Hugh Simon Lam","doi":"10.1002/ped4.70025","DOIUrl":"10.1002/ped4.70025","url":null,"abstract":"<p><strong>Importance: </strong>C-reactive protein (CRP) is a commonly used biomarker for sepsis.</p><p><strong>Objective: </strong>This study aimed to evaluate CRP's diagnostic performance to detect neonatal early-onset sepsis (EOS), while accounting for both gestational and postnatal age.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>Among 100 327 tested neonates, 448 developed culture-confirmed EOS, and 34 had meningitis. In uninfected neonates, CRP concentrations rose naturally after 8 h of life, peaking at 24-32 h, with higher values in term neonates at 24-48 h (median 6.2 mg/L, interquartile range 2.9-14.3). Diagnostic performance was better in preterm neonates (e.g., the area under the ROC curve after 4 h of life: 0.88 in <34 weeks, 0.83-0.92 in 34-36 weeks, and 0.73-0.77 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 value of >12.0 mg/L was associated with increased risk of meningitis.</p><p><strong>Interpretation: </strong>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.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 4","pages":"337-346"},"PeriodicalIF":2.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}