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Open Access Research article

Neonatal infections in Saudi Arabia: association with C-reactive protein, CRP -286 (C>T>A) gene polymorphism and IgG antibodies

Amre Nasr123, Gamal Allam14, Ali Al-Zahrani56 and Adnan Alsulaimani5*

Author Affiliations

1 Department of Microbiology, College of Medicine, Taif University, Taif, Saudi Arabia

2 Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

3 Department of Microbiology, Faculty of Science and Technology, Al-Neelain University, Khartoum, Sudan

4 Department of Zoology, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt

5 Department of Pediatrics, College of Medicine, Taif University, Taif, Saudi Arabia

6 Department of Neonatology, King Abdel Aziz Specialist Hospital (KAASH), Taif, Saudi Arabia

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BMC Immunology 2013, 14:38  doi:10.1186/1471-2172-14-38

Published: 13 August 2013

Abstract

Background

C-reactive protein (CRP) is a nonspecific, acute-phase protein that rises in response to infectious and non-infectious inflammatory processes. Infections are the single largest cause of neonatal deaths globally.

The primary aim of this study is to examine the association between CRP gene polymorphism and serum levels of CRP in correlation with early onset sepsis (EOS) infection in newborns living in Taif city, Saudi Arabia. The second aim is to examine the relationship between specific IgG/IgG subclasses and early onset sepsis (EOS) infection among these newborns.

Methods

Staphylococcus aureus (S. aureus) is one of the most common organisms related to sepsis infection in the newborn at King Abdel Aziz Specialist Hospital (KAASH). This study was conducted in Taif city, at KAASH’s neonatal intensive care unit between March and August 2012. Neonates were consecutively enrolled onto the study having met our inclusion criteria (as per our research protocol).

The CRP concentration level was analysed using NycoCard® CRP Single Test. CRP -286 (C>T>A) A polymorphisms were analyzed using Pyrosequencing technology for CRP genotyping. IgG subclasses were analysed in the study population using ELISA.

Result

Logistic regression analyses showed that the AA and AC genotypes were negatively associated amongst EOS neonates compared to suspected neonates. The frequency of CC and CT were significantly associated with the EOS neonates compared to the suspected group. The levels of specific IgG1, IgG2 and IgG3 antibodies were significantly lower amongst EOS compared to the suspected group.

Conclusions

Taken together, the CRP-286 (C>T>A) A genotype polymorphism and specific IgG antibodies isotype levels can contribute to a reduced risk of EOS. Furthermore, CRP has a potential use in detecting EOS in neonates, which may mean earlier detection and management of EOS and subsequently better clinical outcome.

Keywords:
CRP; CRP gene Polymorphism; IgG subclasses; Early onset sepsis (EOS); Saudi Arabia