Table 1

Test characteristics of C reactive protein (CRP) in the diagnosis of neonatal sepsis

CRP cut point (mg/L), ≥Sensitivity (95% CI)Specificity (95% CI)Youden’s indexArea under the curveReference standard(s)Total Patients, nDisease, n*Studies, nI2
All included studies
 60.76 (0.69 to 0.81)0.77 (0.69 to 0.83)0.530.83 (0.76, 0.85)Blood culture and clinical sepsis29101122242.9–4.2
 100.68 (0.61 to 0.74)0.81 (0.76 to 0.86)0.490.80 (0.73, 0.82)Blood culture and clinical sepsis82431829388.2–10.9
 600.78 (0.67 to 0.86)0.80 (0.66 to 0.89)0.580.85 (0.73, 0.90)Blood culture and clinical sepsis1389576108–11.3
 2.50.76 (0.58 to 0.88)0.86 (0.32 to 0.99)0.620.83 (0.70, 0.93)Blood culture26312430.4–0.5
 50.79 (0.62 to 0.89)0.76 (0.58 to 0.88)0.550.84 (0.72, 0.89)Blood culture100335584.1–7
 60.77 (0.69 to 0.83)0.76 (0.68 to 0.83)0.530.83 (0.75, 0.85)Blood culture2600942213.4–5.2
 80.54 (0.40 to 0.68)0.86 (0.77 to 0.92)0.400.78 (0.65, 0.84)Blood culture1866356103.6–4
 100.69 (0.61 to 0.75)0.81 (0.74 to 0.86)0.500.81 (0.73, 0.82)Blood culture79201733358.3–11.2
 200.79 (0.67 to 0.88)0.73 (0.58 to 0.84)0.520.83 (0.73, 0.86)Blood culture360325181.5–1.7
 500.73 (0.40 to 0.91)0.83 (0.63 to 0.94)0.560.86 (0.60, 0.94)Blood culture963596610.7–19.5
 1000.69 (0.35 to 0.91)0.87 (0.35 to 0.99)0.560.83 (0.47, 0.96)Blood culture53922036.9–8.1
 100.62 (0.50 to 0.73)0.87 (0.76 to 0.94)0.490.77 (0.57, 0.91)Clinical sepsis3239643.4–3.6
High-income countries only
 100.67 (0.57 to 0.75)0.81 (0.73 to 0.87)0.480.80 (0.71, 0.83)Blood culture and clinical sepsis5997994269.5–12.5
 80.58 (0.39 to 0.75)0.87 (0.73 to 0.94)0.450.80 (0.70, 0.86)Blood culture141423971.8–1.9
 100.67 (0.57 to 0.76)0.81 (0.73 to 0.87)0.480.80 (0.71, 0.83)Blood culture5924964259.8–12.8
 200.79 (0.65 to 0.89)0.73 (0.56 to 0.85)0.520.83 (0.71, 0.87)Blood culture355622671.9–2.3
 300.47 (0.35 to 0.59)0.84 (0.80 to 0.88)0.310.59 (0.46, 0.87)Blood culture3666630
 Low- and middle-income countries only
 60.76 (0.71 to 0.81)0.76 (0.67 to 0.83)0.520.82 (0.74, 0.84)Blood culture and clinical sepsis27751046212.8–4.1
 100.70 (0.62 to 0.76)0.82 (0.72 to 0.89)0.520.79 (0.66, 0.84)Blood culture and clinical sepsis2274835125–6.7
 600.78 (0.67 to 0.86)0.8 (0.66 to 0.89)0.580.85 (0.73, 0.90)Blood culture and clinical sepsis1389576108–11.3
 50.80 (0.62 to 0.91)0.76 (0.56 to 0.89)0.560.85 (0.72, 0.90)Blood culture86330374.6–8
 60.77 (0.70 to 0.83)0.74 (0.65 to 0.82)0.510.82 (0.74, 0.85)Blood culture2465866183.4–5.1
 80.44 (0.34 to 0.55)0.82 (0.76 to 0.87)0.260.72 (0.43, 0.84)Blood culture452117310.8–11.7
 100.71 (0.61 to 0.79)0.79 (0.67 to 0.88)0.500.80 (0.68, 0.85)Blood culture2024769105.2–7.4
 120.67 (0.49 to 0.81)0.88 (0.58 to 0.98)0.550.78 (0.60, 0.93)Blood culture3038945.8–6.3
 500.79 (0.38 to 0.96)0.72 (0.50 to 0.87)0.510.80 (0.48, 0.94)Blood culture752558410.7–25
 600.80 (0.71 to 0.87)0.82 (0.70 to 0.90)0.620.87 (0.76, 0.91)Blood culture133955595.9–8.4
 100.66 (0.52 to 0.77)0.89 (0.71 to 0.96)0.550.74 (0.59, 0.93)Clinical sepsis2506630.8–0.9
  • *Defined as positive for disease using reference standard.