scholarly journals Coagulase-NegativeStaphylococcus, Catheter-Related, Bloodstream Infections and their Association with Acute Phase Markers of Inflammation in the Intensive Care Unit: An Observational Study

2012 ◽  
Vol 23 (4) ◽  
pp. 204-208 ◽  
Author(s):  
Oleksa Rewa ◽  
John Muscedere ◽  
Steve Reynolds ◽  
Xuran Jiang ◽  
Daren K Heyland

OBJECTIVE: To examine the relationship between the isolation of coagulase-negativeStaphylococcusin blood cultures and acute phase markers of inflammation.METHODS: The present study was a prospective observational analysis conducted at three medical/surgical intensive care units (ICUs) involving adult patients with an expected ICU stay of more than 24 h duration.RESULTS: Of the 598 patients enrolled, 573 developed suspected bloodstream infection and 434 (72.6%) had blood cultures sent 24 h after ICU admission; 142 were excluded due to positive cultures from other sites. Of the remaining 292 patients, 31 (10.7%) grew coagulase-negativeStaphylococcus, 59 (20.2%) grew known pathogenic organisms and 202 (69.2%) did not grow any organisms in their blood cultures. Twenty-five patients without suspicion of infection served as the control group. Interleukin (IL)-6, procalcitonin (PCT) and C-reactive protein (CRP) levels were highest among the known pathogen group (IL-6 271.8 U/L, PCT 4.6 U/L and CRP 164 mg/L), were similar between the coagulase-negativeStaphylococcusand negative culture groups (IL-6 67.0 U/L versus 61.4 U/L [P=1.00]; PCT 1.0 U/L versus 0.9 U/L [P=0.80]; and CRP 110 mg/L versus 103 mg/L [P=0.75]), and were lowest in the control group (IL-6 31.0 U/L, PCT 0.2 U/L and CRP 41.0 mg/L). In the coagulase-negativeStaphylococcusgroup, patients who died by day 28 had increased inflammatory bio-marker levels compared with survivors, although the differences were not statistically significant.CONCLUSIONS: Coagulase-negativeStaphylococcusisolated from blood cultures were associated with lower levels of inflammation compared with bloodstream infections due to known pathogens and were comparable with levels in patients with negative cultures.

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Makrouhi Sonikian ◽  
Aggeliki Barbatsi ◽  
Eugenia Karakou ◽  
Theodoros Chiras ◽  
Jacob Skarakis ◽  
...  

Abstract Introduction C-reactive protein (CRP) and procalcitonin (PCT) are widely used as markers of inflammation and infection in general population and in chronic hemodialysis (HD) as well. However, in dialysis (D) patients, serum CRP and PCT levels may be elevated even in the absence of inflammatory or infectious disease and diagnostic process is a challenge in such cases. We studied HD patients' laboratory profile concerning CRP and PCT. Subjects and Methods We studied 25 stable HD patients, M/F=22/3, aged 68(44-89) years, dialyzed thrice weekly for 55(6-274) months with a dialysate flow rate of 700 ml/min, with a residual daily diuresis less than 200 ml, Kt/V values of 1,44±0,3 and no signs of infection. Patients were classified in two groups. Group A included 10 patients on pre-dilution online hemodiafiltration (HDF). Group B consisted of 15 patients on conventional HD with low-flux polysulfone membrane. Twenty healthy subjects formed a control group C. Serum CRP and PCT levels were measured in duplicate in A and B groups before and at the end of mid-week dialysis sessions and also in C group. Results Pre-D serum CRP values in the total of patients were higher than those in healthy controls (10,89±19,29 vs 2,54±1,28 mg/L-p=0,004). Compared with group C, pre-D CRP values were higher only in B group (15,98±24,54 mg/L-p=0,001) but not in A group (4,09±3,33 mg/L-p=NS). There was a significant difference in pre-D serum CRP values between A and B groups (p=0,028). At the end of D session serum CRP values showed a tendency to increase in both groups A (5,16±4,81 mg/L) and B (17,00±27,00 mg/L) but differences were not significant. Pre-D serum PCT values in the total of patients were higher than those in healthy controls (0,82±0,9 vs 0,29±0,55 ng/ml-p<0,001). Compared with group C, pre-D PCT values were higher in both A group (0,52±0,15 ng/ml-p<0,001) and B group (1,01±1,13 ng/ml-p=0,006). There was no significant difference in pre-D serum PCT values between A and B groups (p=0,261). At the end of D session serum PCT values decreased in A group (0,32±0,11 ng/ml-p<0,001) and increased in B group (1,12±1,21 ng/ml-p=0,014). Conclusions In patients on both conventional low-flux HD and online HDF pre-D serum CRP and PCT levels were higher than those in healthy subjects. Dialysis modality and membrane flux did not affect post-D serum CRP values, but post-PCT values decreased in online HDF. PCT usefulness might be limited in dialysis with high-flux membranes. Cut-off values have to be established for both markers to eliminate confusion in diagnosis of inflammatory and infectious diseases in hemodialyzed patients.


Author(s):  
Hakan Guzel ◽  
Sahin Kahramanca ◽  
Oskay Kaya ◽  
Gulay Ozgehan ◽  
Demet Yilmazer ◽  
...  

The need and timing of surgical intervention in patients with adhesive bowel obstruction is a dilemma. We aimed to investigate the role of three acute-phase reactants, namely procalcitonin (PCT), fibrinogen and C-reactive protein (CRP) in this clinical condition We chose a rat model whose mechanical bowel obstruction was created with caecum ligation. There were two study groups and one control group. Each group contained ten subjects. The study groups had and six-hour obstruction samples. Blood PCT, fibrinogen and CRP levels were measured before and after the surgical procedure. These parameters were compared between the groups and they were also evaluated with the degree of histopathological changes occurred in terminal ileal tissue samples. Compared with the control group, PCT measurements showed a mild decrease in the early phase of obstruction but a significant elevation in the late phase (p: 0,977 and p: 0,001). Unlike PCT, fibrinogen levels increased at first but decreased later (p: 0,978 and p: 0,326). We observed an increase in CRP levels parallel to the prolonged duration of obstruction (p: 0,987 and p: 0,134). With regard to mucosal injury, PCT levels increased at first, and then decreased (p: 0,003). On the other hand, fibrinogen and CRP levels decreased at first, and then increased (p: 0,139 and p: 0,102). The acute-phase reactants PCT, fibrinogen and CRP associated with the duration of obstruction may help to determine the time of surgical intervention in patients with adhesive mechanical bowel obstruction.


2009 ◽  
Vol 127 (6) ◽  
pp. 350-354 ◽  
Author(s):  
Domingos Dias Cicarelli ◽  
Joaquim Edson Vieira ◽  
Fábio Ely Martins Benseñor

CONTEXT AND OBJECTIVE: C-reactive protein (CRP) is commonly used as a marker for inflammatory states and for early identification of infection. This study aimed to investigate CRP as a marker for infection in patients with postoperative septic shock. DESIGN AND SETTING: Prospective, single-center study, developed in a surgical intensive care unit at Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. METHODS: This study evaluated 54 patients in the postoperative period, of whom 29 had septic shock (SS group) and 25 had systemic inflammatory response syndrome (SIRS group). All of the patients were monitored over a seven-day period using the Sequential Organ Failure Assessment (SOFA) score and daily CRP and lactate measurements. RESULTS: The daily CRP measurements did not differ between the groups. There was no correlation between CRP and lactate levels and the SOFA score in the groups. We observed that the plasma CRP concentrations were high in almost all of the patients. The patients presented an inflammatory state postoperatively in response to surgical aggression. This could explain the elevated CRP measurements, regardless of whether the patient was infected or not. CONCLUSIONS: This study did not show any correlation between CRP and infection among patients with SIRS and septic shock during the early postoperative period.


Angiology ◽  
2016 ◽  
Vol 68 (4) ◽  
pp. 354-359 ◽  
Author(s):  
Chong-Rong Qiu ◽  
Qiang Fu ◽  
Jian Sui ◽  
Qian Zhang ◽  
Peng Wei ◽  
...  

Endothelial dysfunction is involved in the process of acute myocardial infarction (AMI), that is, the endothelial cell–specific molecule 1 (ESM-1; endocan) is a novel endothelial dysfunction marker. However, the relationship between patients with AMI and serum ESM-1 levels is not very clear. Patients with AMI (n = 216) and a control group (n = 60) without AMI were included in the study. High-sensitivity C-reactive protein (hsCRP) was measured, and the severity of AMI was assessed by a modified Gensini stenosis scoring system. Serum ESM-1 levels were significantly higher in the AMI group ( P < .05). High-sensitivity C-reactive protein levels were also significantly higher in the AMI group ( P < .05). In patients with AMI, serum ESM-1 levels were not significantly correlated with hsCRP levels. There was no significant correlation between serum ESM-1 level and Gensini score. Our findings suggest that serum ESM-1 levels may be a novel biomarker of endothelial dysfunction in patients with AMI.


1953 ◽  
Vol 98 (4) ◽  
pp. 321-329 ◽  
Author(s):  
Harrison F. Wood

The ability of an adjuvant and its individual constituents to induce the production of Cx-reactive protein in rabbits has been studied. It was found that the adjuvant stimulated rabbits to produce large amounts of the acute phase protein for 3 to 6 days. Melted aquaphor blended with saline stimulated the production of Cx-reactive protein for 3 or 4 days. Mineral oil was less effective in stimulating the production of the protein than either adjuvant or aquaphor. Heat-killed Jamaica strain tubercle bacilli suspended in mineral oil did not induce the Cx-protein response. The ability of subcutaneously administered adjuvant without antigen incorporated in the saline phase to potentiate the antibody response of rabbits to the intravenously administered antigens, C-reactive protein and human gamma globulin, was investigated. It was found that the adjuvant-treated animals produced more precipitating antibody to the two intravenously administered antigens than did the control animals given intravenous antigen alone.


2002 ◽  
Vol 30 (6) ◽  
pp. 591-596 ◽  
Author(s):  
İ İyigün ◽  
Y Bakirci

This study investigated how fibrinogen and C-reactive protein (CRP) levels change in response to neural damage occurring after ischaemia, and the relationship between the distribution of the arterial lesion, the disease prognosis and the levels of these substances. Fibrinogen and CRP levels were measured in blood samples obtained from 83 patients admitted to hospital within 72 h of a first ischaemic stroke. The patients were evaluated clinically with the Glasgow Outcome Scale (GOS), and results were compared with 43 age-matched controls. The fibrinogen and CRP levels in unconscious patients with hemiparesis or hemiplegia were higher than those in conscious hemiplegic patients. Also, the difference in GOS values between the unconscious patients with hemiparesis or hemiplegia and conscious patients with hemiparesis or hemiplegia was statistically significant. Patients with large infarcts in the median cerebral artery and anterior cerebral artery had higher fibrinogen and CRP concentrations than the control group. In conclusion, fibrinogen and CRP may be important measures for determining the prognosis and outcome in patients following ischaemic stroke.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ertuğrul Kurtoğlu ◽  
Hasan Korkmaz ◽  
Erdal Aktürk ◽  
Mücahid Yılmaz ◽  
Yakup Altaş ◽  
...  

Objectives. There are limited clinical data revealing the relationship between mitral annular calcification (MAC) and systemic inflammation. The goal of the present study was to compare high-sensitivity C-reactive protein (hs-CRP) levels in patients with and without MAC and investigate the relationship between MAC and hs-CRP.Methods. One hundred patients with MAC who underwent transthoracic echocardiography (TTE) and 100 age-matched controls without MAC who underwent TTE were included in our study. Hs-CRP levels were compared between groups.Results. Prevalence of female gender, hypertension, and coronary artery disease were significantly higher in the MAC group than in the control group (64% versus 45%,P=0.007, 42% versus 28%,P=0.03and 37% versus 18%,P=0.003, resp.). On multivariate analysis, age, gender, and coronary artery disease were the only independent predictors of MAC. The levels of hs-CRP were higher in the MAC group than in the control group (2.02±0.35versus1.43±0.47 mg/dl,P<0.001). This increase in hs-CRP levels in the MAC group persisted in patients without hypertension, coronary artery disease, and in male patients when compared to the control group.Conclusions. Our study demonstrated that hs-CRP, which is a sensitive marker of systemic inflammation, increased in patients with MAC.


2015 ◽  
Vol 96 (3) ◽  
pp. 294-297
Author(s):  
T Z Zakiev ◽  
S R Tuysin ◽  
A R Gil’fanov ◽  
R D Sagdiev ◽  
I V Zakieva

Aim. To assess the significance of acute stage reactants as the marker for purulent complications in surgical patients.Methods. We analyzed the results of treatment of 228 patients with purulent and inflammatory diseases of soft tissues, treated in 2011-2014. Acute phase reactants: C-reactive protein, albumin and fibrinogen were measured starting from the day of admission and surgical treatment and during the next 7 days. The control group (112 patients) included patients whowere treated conventionally by gauze bandage with water-soluble ointments and antiseptic solutions and broad-spectrum antibiotics. In the study group (116 patients) topical treatment of wounds was performed using «Poliderm» bandages.Results. Application of the «Poliderm» combined dressing reduced the wounds clearance term from 4.3±0.5 to 3.2±0.4 days, active inflammation term from 8.8±1.3 to 6.4±0.7 days, epithelialization of the wound from 10.1±0.8 to 8.4±0.6 days. C-reactive protein level was 87.3±4.3 g/l at the day of admission and decreased by day 7 to 34.13±1.2 g/l, compared to 51.83±3.6 g/l on the 7th day in the control group. Albumin level was 42.73±3.7 g/l in the study group with further decrease to 40.33±1.7 g/l on the 2nd and subsequent increase up to 45.13±1.3 g/l on the day 7. Patients of the control group had albumin level decreased on the 2nd and 3rd days with further increase up to 41.73±2.1 g/l on the day 7. At the treatment start, leukocyte intoxication index was 5.923±0.4 in the main group and 5.873±0.3 in the control group. On the 2nd day, this parameter decreased to 5.12 in the main group and to 5.41 in the control group.Conclusion. Measuring the levels of acute phase reactants (C-reactive protein, albumin, etc.) allows to assess the clinical course of a purulent and inflammatory disease, to register the good treatment effect on the 1-2nd day of treatment, even before the significant clinical changes, changes in the body temperature, white blood cell counts, erythrocyte sedimentation rate.


2021 ◽  
pp. 1-4
Author(s):  
Bharat L. Konin ◽  
Shiney Aggarwal ◽  
Swaraj S. Waddankeri

Background and Purpose: The measurement of markers of inflammation or thrombosis has been proposed as a method to improve the prediction of risk in patients with vascular disease. The role of C-reactive protein (CRP) as a novel plasma marker of atherothrombotic disease is currently under investigation. We related age and gender predilection of plasma CRP levels to first ever ischemic stroke and its role on mortality. Methods: Sixty patients with either hypertension or diabetes or both or none without thrombolysis with first ever acute ischemic stroke patients were examined. CT scan of brain was done after 24 hours of onset of symptoms to confirm the diagnosis. Plasma CRP level was determined after 12 - 72 hours range after the onset of symptoms in all CT confirmed ischemic stroke patients. This clinical study was done during June 2018 to January 2020. CRP was randomly measured in 60 age and sex matched individuals admitted in other wards of the hospital matched in all possible criteria expect the disease under study as a control group. Results: The CRP concentration in ischemic strokes is independent of infarction site, the value was more between 51-70 years of age group and almost equal in both gender. 54 of the 60 ischemic strokes studied had CRP value >6 mg/l and only 6 patients had <6 mg/l (p<0.001), chi square test value is ²=73.65 which is statistically significant. Only 7 of the 60 control group had CRP >6 mg/l. Conclusion: In this study mean C-Reactive protein levels were significantly higher in patients with ischemic stroke when compared to controls. C-reactive protein level increases as age advances. C-reactive protein is a better prognostic marker with no gender predilection and not a mortality predictor.


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