Synovial C-reactive protein features high negative predictive value but is not useful as a single diagnostic parameter in suspected periprosthetic joint infection (PJI)

2019 ◽  
Vol 78 (6) ◽  
pp. 439-444 ◽  
Author(s):  
A. Plate ◽  
A. Anagnostopoulos ◽  
J. Glanzmann ◽  
L. Stadler ◽  
L. Weigelt ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Periprosthetic Joint Infection ◽  
Predictive Value ◽  
Joint Infection ◽  
Diagnostic Parameter ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
High Negative Predictive Value

scholarly journals Assessment of a Multiplex Serological Test for the Diagnosis of Prosthetic Joint Infection: a Prospective Multicentre Study

2020 ◽  
Vol 5 (2) ◽  
pp. 89-95 ◽  
Author(s):  
Pascale Bémer ◽  
Céline Bourigault ◽  
Anne Jolivet-Gougeon ◽  
Chloé Plouzeau-Jayle ◽  
Carole Lemarie ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Serological Test ◽  
Bacterial Species ◽  
Joint Infection ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Cutibacterium Acnes

Abstract. Introduction: The diagnosis of prosthetic joint infections (PJIs) can be difficult in the chronic stage and is based on clinical and paraclinical evidence. A minimally invasive serological test against the main pathogens encountered during PJI would distinguish PJI from mechanical loosening.Methods: We performed a prospective, multicentre, cross-sectional study to assess the contribution of serology in the diagnosis of PJI. Over a 2-year period, all patients undergoing prosthesis revision were included in the study. A C-reactive protein assay and a serological test specifically designed against 5 bacterial species (Staphylococcus aureus, S. epidermidis, S. lugdunensis, Streptococcus agalactiae, Cutibacterium acnes) were performed preoperatively. Five samples per patient were taken intraoperatively during surgery. The diagnosis of PJI was based on clinical and bacteriological criteria according to guidelines.Results: Between November 2015 and November 2017, 115 patients were included, 49 for a chronic PJI and 66 for a mechanical problem. Among patients with PJI, a sinus tract was observed in 32.6% and a C-reactive protein level ≥10 mg/L in 74.5%. The PJI was monomicrobial in 43 cases (targeted staphylococci, 24; S. agalactiae, 1; C. acnes, 2; others, 16), and polymicrobial in 6 cases (12.2%). Sensitivity, specificity, positive predictive value and negative predictive value were 75.0%, 82.1%, 58.3% and 90.8%, respectively, for targeted staphylococci. Specificity/negative predictive value was 97.3%/100% for S. agalactiae and 83.8% /96.9% for C. acnes.Conclusions: The serological tests are insufficient to affirm the diagnosis of PJI for the targeted bacteria. Nevertheless, the excellent NPV may help clinicians to exclude PJI.

scholarly journals Is Synovial C-reactive Protein a Useful Marker for Periprosthetic Joint Infection?

2014 ◽  
Vol 472 (12) ◽  
pp. 3997-4003 ◽  
Author(s):  
Matthew W. Tetreault ◽  
Nathan G. Wetters ◽  
Mario Moric ◽  
Christopher E. Gross ◽  
Craig J. Della Valle
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Protein A ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals A study on validity of C-reactive protein in deciding the duration of antibiotic therapy in suspected neonatal bacterial infection

2017 ◽  
Vol 4 (5) ◽  
pp. 1838 ◽  
Author(s):  
Prashanth Siddaiah ◽  
Pradeep Nanjappa Shetty ◽  
Krishna N. W. ◽  
Sowmya Jagadeeshwara
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Negative Predictive Value ◽  
Antibiotic Treatment ◽  
Predictive Value ◽  
Decision Criterion ◽  
C Reactive Protein ◽  
Neonatal Septicemia ◽  
Reactive Protein ◽  
Serum Crp

Background: Neonatal septicemia is defined as generalized bacterial infection of newborns documented by positive blood culture in first four weeks of life. Objective of present study was to determine whether C-Reactive protein can be used as a parameter to identify the time point when antibiotic treatment can safely be discontinued in a defined major subgroup of neonates treated for suspected bacterial infection.Methods: A total of 50 neonates with birth weight more than 1500gms with suspected septicemia were enrolled in the prospective study. Serum CRP were determined 24-48 hours after the first dose of antibiotics. If CRP was less than 6mg/l, infants were considered unlikely to be infected and the antibiotic treatment was stopped. If CRP was more than 6mg/l, antibiotics were continued and CRP measured on alternative days in one subgroup (2a) and on seventh day in another subgroup (2b). CRP was the single decision criterion to stop the antibiotic therapy. Negative predictive value with respect to further treatment was determined.Results: Duration of antibiotic therapy could be reduced to less than seven days in 54% cases and < 72 hours in 48% cases.Conclusions: Negative predictive value of serial CRP is 100% in deciding the duration of antibiotic therapy in suspected neonatal septicemia.

scholarly journals Procalcitonin and C-Reactive Protein/Procalcitonin Ratio as Markers of Infection in Patients With Solid Tumors

2021 ◽  
Vol 8 ◽  
Author(s):  
Matteo Vassallo ◽  
Celine Michelangeli ◽  
Roxane Fabre ◽  
Sabrina Manni ◽  
Pierre L. Genillier ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Cancer Patients ◽  
Negative Predictive Value ◽  
Solid Tumors ◽  
Predictive Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Documented Infection ◽  
Baseline Levels ◽  
Sensitive Marker

Objectives: The roles of procalcitonin (PCT) and C-reactive protein (CRP) in febrile cancer patients is currently unclear. Our aim was to assess these in febrile patients with solid tumors and to identify cut-off values for ruling out infection.Methods: We retrospectively evaluated patients with solid tumors admitted to hospital due to fever. They were divided into those with Fever with microbiologically documented infection (FMDI), Fever with clinically documented infection (FCDI) and Tumor-related fever (TRF). PCT and CRP levels were compared. Receiver-operating curves were plotted to define the best cut-off values for discriminating between infection-related and cancer-related fever.Results: Between January 2015 to November 2018, 131 patients were recorded (mean age 68 years, 67% male, 86% with metastasis). Patients with FMDI or FCDI had significantly higher baseline levels of PCT and lower CRP/PCT than those with TRF. A PCT cut-off value of 0.52 ng/mL for discriminating between infection and cancer-associated fever yielded 75% sensitivity, 55% specificity, 77% positive predictive value (PPV), and 52% negative predictive value (NPV). A CRP/PCT ratio with a cut-off value of 95 showed 56% sensitivity, 70% specificity, 79% NPV, and 44% PPV.Discussion: PCT is a sensitive marker of sepsis or localized infection in patients with solid tumors, but its specificity is poor. The CRP/PCT ratio improves specificity, thus providing a reliable means of ruling out infection for values above 95.

Clinical Evaluation of Synovial Alpha Defensin and Synovial C-Reactive Protein in the Diagnosis of Periprosthetic Joint Infection

2018 ◽  
Vol 100 (14) ◽  
pp. 1184-1190 ◽  
Author(s):  
William Z. Stone ◽  
Chancellor F. Gray ◽  
Hari K. Parvataneni ◽  
Mamun Al-Rashid ◽  
Richard G. Vlasak ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals C-reactive protein is not a screening tool for late periprosthetic joint infection

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Bernd Fink ◽  
Michael Schlumberger ◽  
Julian Beyersdorff ◽  
Philipp Schuster
Keyword(s):  
Periprosthetic Joint Infection ◽  
Screening Tool ◽  
Joint Infection ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals C-reactive protein, as a marker for predicting acute appendicitis and its severity in KVG medical college and hospital, Sullia

2021 ◽  
Vol 8 (10) ◽  
pp. 3002
Author(s):  
Abhirup H. Ramu ◽  
Priyanka Kenchetty ◽  
Aishwarya K. Chidananda
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Clinical Suspicion ◽  
C Reactive Protein ◽  
Common Procedure ◽  
Medical College ◽  
Reactive Protein

Background: Appendicectomy for suspected acute appendicitis is a common procedure. The rate of normal appendices unnecessarily removed remains high despite several techniques and investigations used to improve the diagnostic accuracy. This study emphasizes the value of C reactive protein (CRP) in three groups of patients operated for clinical suspicion of acute appendicitis with different finding at appendicectomy namely an un-inflamed appendix, uncomplicated acute appendicitis or complicated acute appendicitis.Methods: This prospective study was performed on 100 consecutive patients who were operated on for treatment of acute appendicitis in KVG medical college and hospital between 01 August 2019 to 01 February 2021. Clinically proven by a surgeon, patients underwent appendicectomy. Serum CRP results of all patients were determined. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Statistical analysis will be made using descriptive statistic and SPSS version 21 was used for analysis.Results: The percentage of negative laparotomies was 13% and surgeon ‘s clinical suspicion was true in 87%. Preoperative CRP values were false negative in 21 patients with appendicitis and false positive in 2 patients with normal appendix. The difference of true and false results between CRP tests and surgeon’s diagnosis was statistically significant (p=0.001). Present study revealed, sensitivity=76%, specificity=87.5%, positive predictive value=96% and negative predictive value=41%.Conclusions: Serum C reactive protein when elevated supports the surgeon’s clinical diagnosis of acute appendicitis. It can be used frequently to diagnosis the acute appendicitis, so that the complication rate and negative laparotomies can be avoided. 

scholarly journals Trend of serum C-reactive protein is associated with treatment outcome of hip Periprosthetic joint infection undergoing two-stage exchange arthroplasty: a case control study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhong-Yan Li ◽  
Yu-Chih Lin ◽  
Chih-Hsiang Chang ◽  
Szu-Yuan Chen ◽  
Tung-Wu Lu ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Treatment Failure ◽  
Periprosthetic Joint Infection ◽  
Kidney Diseases ◽  
Joint Infection ◽  
Multivariate Logistic Regression Analysis ◽  
C Reactive Protein ◽  
Two Stage ◽  
Reactive Protein ◽  
Exchange Arthroplasty

Abstract Background Serum C-reactive protein (CRP) trends are critical for monitoring patients’ treatment response following a two-stage exchange arthroplasty for periprosthetic joint infection (PJI) of the hip. However, CRP trends are poorly described in the literature. The primary aim of this study was to identify the relationships between PJI treatment outcomes and our proposed CRP trend definitions, parameters, and microbiological data. The secondary aim was to investigate CRP trends after the occurrence of spacer-related complications. Methods We conducted a retrospective review of 74 patients treated with a two-stage exchange protocol for PJI in a tertiary referral joint center between 2014 and 2016. Patients with factors that may affect CRP levels (inflammatory arthritis, concomitant infections, liver and kidney diseases, and intensive care admissions) were excluded. CRP trends were categorized into five types and PJI treatment outcome was defined as “success” or “failure” according to the Delphi criteria. Results Treatment was successful in 67 patients and failed in 7 patients. Multivariate logistic regression analysis showed that type 5 CRP, defined as serum CRP fluctuation without normalization after first stage surgery (odds ratio [OR]: 17.4; 95% confidence interval [CI]: 2.3–129.7; p = 0.005), and methicillin-resistant Staphylococcus aureus (MRSA; OR: 14.5; 95% CI: 1.6–131.7; p = 0.018) were associated with treatment failure. Spacer-related complications occurred in 18 patients. Of these, 12 had elevated CRP levels at later follow-up, while six had no elevation in CRP levels. Conclusions We found that MRSA infection and type 5 CRP were associated with PJI treatment failure.

Sign in / Sign up

Export Citation Format

Share Document