scholarly journals Evolution of laboratory markers for systemic bacterial infections

2017 ◽  
Vol 89 (11) ◽  
pp. 105-110
Author(s):  
N L Ryabkova ◽  
N N Vezikova
Keyword(s):  
Bacterial Infection ◽  
Proinflammatory Cytokines ◽  
Bacterial Infections ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Laboratory Markers ◽  
Systemic Bacterial Infection

The paper reviews the data available in the literature on existing laboratory markers for systemic bacterial infection, among which C-reactive protein, proinflammatory cytokines, procalcitonin test, and presepsin receive primary emphasis.

scholarly journals C-Reactive Protein Is an Independent Predictor of 30-Day Bacterial Infection Post-Liver Transplantation

Biomolecules ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1195
Author(s):  
Jiong Yu ◽  
Xiaowei Shi ◽  
Jing Ma ◽  
Ronggao Chen ◽  
Siyi Dong ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Bacterial Infection ◽  
Systemic Inflammation ◽  
Bacterial Infections ◽  
Cox Regression ◽  
Prognostic Models ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Clinically Significant ◽  
The Relationship

The relationship between aseptic systemic inflammation and postoperative bacterial infection is unclear. We investigated the correlation of systemic inflammation biomarkers with 30-day clinically significant bacterial infections (CSI) after liver transplantation (LT). This retrospective study enrolled 940 patients who received LT and were followed for 30 days. The primary end point was 30-day CSI events. The cohort was divided into exploratory (n = 508) and validation (n = 432) sets according to different centers. Area under the receiver operated characteristic (AUROC) and Cox regression models were fitted to study the association between baseline systemic inflammation levels and CSI after LT. A total of 255 bacterial infectious events in 209 recipients occurred. Among systemic inflammation parameters, baseline C-reactive protein (CRP) was independently associated with 30-day CSI in the exploratory group. The combination of CRP and organ failure number showed a good discrimination for 30-day CSI (AUROC = 0.80, 95% CI, 0.76–0.84) and the results were confirmed in an external verification group. Additionally, CRP levels were correlated with bacterial product lipopolysaccharide. In conclusion, our study suggests that pre-transplantation CRP is independent of other prognostic factors for 30-day CSI post-LT, and can be integrated into tools for assessing the risk of bacterial infection post-LT or as a component of prognostic models.

scholarly journals Cytokines and Chemokines as Biomarkers of Community-Acquired Bacterial Infection

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Michal Holub ◽  
David A. Lawrence ◽  
Nancy Andersen ◽  
Alžběta Davidová ◽  
Ondřej Beran ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Elevated Serum ◽  
Serum Concentrations ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Cytokines And Chemokines ◽  
Luminex Technology ◽  
Limited Usefulness

Routinely used biomarkers of bacterial etiology of infection, such as C-reactive protein and procalcitonin, have limited usefulness for evaluation of infections since their expression is enhanced by a number of different conditions. Therefore, several inflammatory cytokines and chemokines were analyzed with sera from patients hospitalized for moderate bacterial and viral infectious diseases. In total, 57 subjects were enrolled: 21 patients with community-acquired bacterial infections, 26 patients with viral infections, and 10 healthy subjects (control cohorts). The laboratory analyses were performed using Luminex technology, and the following molecules were examined: IL-1Ra, IL-2, IL-4, IL-6, IL-8, TNF-α, INF-γ, MIP-1β, and MCP-1. Bacterial etiology of infection was associated with significantly (P<0.001) elevated serum concentrations of IL-1Ra, IL-2, IL-6, and TNF-αin comparison to levels observed in the sera of patients with viral infections. In the patients with bacterial infections, IL-1Ra and IL-8 demonstrated positive correlation with C-reactive protein, whereas, IL-1Ra, TNF-α, and MCP-1 correlated with procalcitonin. Furthermore, elevated levels of IL-1Ra, IL-6, and TNF-αdecreased within 3 days of antibiotic therapy to levels observed in control subjects. The results show IL-1Ra as a potential useful biomarker of community-acquired bacterial infection.

scholarly journals Procalcitonin as an Acute Phase Marker

2001 ◽  
Vol 38 (5) ◽  
pp. 483-493 ◽  
Author(s):  
John Whicher ◽  
Jacques Bienvenu ◽  
Guillaume Monneret
Keyword(s):  
Bacterial Infection ◽  
Acute Phase ◽  
Acute Phase Proteins ◽  
Gene Products ◽  
Bacterial Sepsis ◽  
C Reactive Protein ◽  
Blood Concentrations ◽  
Reactive Protein ◽  
Specificity And Sensitivity ◽  
Systemic Bacterial Infection

Procalcitonin is a 14-kDa protein encoded by the Calc-I gene along with calcitonin and katacalcin. The function and regulation of this protein are quite different from those of the other gene products. Blood concentrations of procalcitonin are increased in systemic inflammation, especially when this is caused by bacterial infection. Studies of its behaviour in patients with bacterial sepsis have led to the proposal that it may be a useful marker of systemic bacterial infection, with greater specificity and sensitivity than acute phase proteins such as C-reactive protein.

scholarly journals C-reactive protein and procalcitonin for antimicrobial stewardship in COVID-19

Infection ◽  
2021 ◽  
Author(s):  
Isabell Pink ◽  
David Raupach ◽  
Jan Fuge ◽  
Ralf-Peter Vonberg ◽  
Marius M. Hoeper ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Roc Analysis ◽  
Secondary Infection ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Secondary Bacterial Infection ◽  
Reactive Protein ◽  
Tract Infections

Abstract Purpose Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory coronavirus 2 (SARS-CoV-2) has spread around the world. Differentiation between pure viral COVID-19 pneumonia and secondary infection can be challenging. In patients with elevated C-reactive protein (CRP) on admission physicians often decide to prescribe antibiotic therapy. However, overuse of anti-infective therapy in the pandemic should be avoided to prevent increasing antimicrobial resistance. Procalcitonin (PCT) and CRP have proven useful in other lower respiratory tract infections and might help to differentiate between pure viral or secondary infection. Methods We performed a retrospective study of patients admitted with COVID-19 between 6th March and 30th October 2020. Patient background, clinical course, laboratory findings with focus on PCT and CRP levels and microbiology results were evaluated. Patients with and without secondary bacterial infection in relation to PCT and CRP were compared. Using receiver operating characteristic (ROC) analysis, the best discriminating cut-off value of PCT and CRP with the corresponding sensitivity and specificity was calculated. Results Out of 99 inpatients (52 ICU, 47 Non-ICU) with COVID-19, 32 (32%) presented with secondary bacterial infection during hospitalization. Patients with secondary bacterial infection had higher PCT (0.4 versus 0.1 ng/mL; p = 0.016) and CRP (131 versus 73 mg/L; p = 0.001) levels at admission and during the hospital stay (2.9 versus 0.1 ng/mL; p < 0.001 resp. 293 versus 94 mg/L; p < 0.001). The majority of patients on general ward had no secondary bacterial infection (93%). More than half of patients admitted to the ICU developed secondary bacterial infection (56%). ROC analysis of highest PCT resp. CRP and secondary infection yielded AUCs of 0.88 (p < 0.001) resp. 0.86 (p < 0.001) for the entire cohort. With a PCT cut-off value at 0.55 ng/mL, the sensitivity was 91% with a specificity of 81%; a CRP cut-off value at 172 mg/L yielded a sensitivity of 81% with a specificity of 76%. Conclusion PCT and CRP measurement on admission and during the course of the disease in patients with COVID-19 may be helpful in identifying secondary bacterial infections and guiding the use of antibiotic therapy.

scholarly journals Thrombocytosis as a Predictor of Serious Bacterial Infection in Febrile Infants

2019 ◽  
Vol 16 (41) ◽  
pp. 401-404
Author(s):  
Deepak Mishra ◽  
Amit Kumar Das ◽  
Ram Hari Chapagain ◽  
Nitu Kumari Jha ◽  
Ganesh Kumar Rai
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Diagnostic Marker ◽  
Common Finding ◽  
P Value ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Young Infants

Background: Most of the febrile infants <90 days old will have no more than a mild viral infection but there is a substantial minority that will be diagnosed as having serious bacterial infection at a reported prevalence of 10–14%. A simple, readily available, inexpensive diagnostic marker that yields results quickly and also accurately identifies bacterial infections in febrile infants would be of great value in management of these infants. This study aims to assess the role of thrombocytosis in predicting serious bacterial infection in young febrile infants beyond neonatal period.Methods: A hospital based cross-sectional observational study was conducted from May 2016 to April 2017 on 76 febrile infants of age group 29-90 days in Kanti Children’s Hospital.Results: The incidence of serious bacterial infection was found 43 (56.6%). Thrombocytosis, elevated C-reactive protein and pyuria were significantly higher in serious bacterial infection cases (p value <0.05). Thrombocytosis alone had the sensitivity of only 53.5%, but had specificity of 90.9%. Elevated C-reactive protein had the best sensitivity (81.4%). Combination of leukocytosis, elevated C-reactive protein, pyuria and thrombocytosis had better sensitivity (93.0%) than these parameters alone. The overall ability of platelet count to identify infants with SBI was only moderate (AUC: 0.722). Elevated C-reactive protein was found to have better ability to identify infants with serious bacterial infection (AUC: 0.846).Conclusions: Thrombocytosis is a common finding in young infants diagnosed with serious bacterial infection. It has however, moderate ability in identifying infants with serious bacterial infection. Combining thrombocytosis with elevated C-reactive protein, leukocytosis and pyuria has better sensitivity in diagnosing serious bacterial infection than these individual parameters alone. Hence, combining these parameters may help in early prediction of febrile young infants at risk of serious bacterial infection.Keywords: Febrile young infants; serious bacterial infection; thrombocytosis.

scholarly journals Potential usefulness of C-reactive protein and procalcitonin determination in patients admitted for neurological disorders in rural Democratic Republic of Congo

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Emmanuel Bottieau ◽  
Deby Mukendi ◽  
Jean-Roger Lilo Kalo ◽  
Pascal Lutumba ◽  
Barbara Barbé ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Neurological Disorders ◽  
Bacterial Infections ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Single Case ◽  
C Reactive Protein ◽  
Republic Of Congo ◽  
Reactive Protein ◽  
Invasive Bacterial Infection

Abstract In low-resource hospitals of central Africa, neurological disorders are frequent and etiologies very diverse. The difficulty to identify invasive bacterial infections in this setting results in major antibiotic overuse. Biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT) may help discriminate these conditions. We retrospectively determined the concentrations of CRP and PCT in the sera of patients consecutively enrolled from 2012 to 2015 in an etiological study on neurological disorders at the rural hospital of Mosango, Democratic Republic of Congo. Invasive bacterial infection had been diagnosed by the demonstration of a bacterial pathogen in cerebrospinal fluid or blood cultures or the presence of radiological pneumonia. Sera of 313 (89.2%) and 317 (90.3%) of the 351 enrolled participants were available for determination of CRP and PCT concentrations respectively. Areas under the receiver operating characteristic curves for invasive bacterial infection, diagnosed in 19 tested cases, were 94.3% for CRP and 91.7% for PCT. No single case had a normal CRP concentration (<10 mg/L). Our data, although limited, suggest that CRP or PCT concentrations may help discriminate invasive bacterial infections in patients with neurological disorders in tropical settings and that normal CRP values could assist in withholding antibiotics.

scholarly journals C-reactive protein or procalcitonin combined with rhinorrhea for discrimination of viral from bacterial infections in hospitalized adults in non-intensive care units with lower respiratory tract infections

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shengchen Duan ◽  
Xiaoying Gu ◽  
Guohui Fan ◽  
Fei Zhou ◽  
Guangfa Zhu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Bacterial Infection ◽  
Lower Respiratory Tract ◽  
Bacterial Infections ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Tract Infections

Abstract Background Whether procalcitonin (PCT) or C-reactive protein (CRP) combined with certain clinical characteristics can better distinguish viral from bacterial infections remains unclear. The aim of the study was to assess the ability of PCT or CRP combined with clinical characteristics to distinguish between viral and bacterial infections in hospitalized non-intensive care unit (ICU) adults with lower respiratory tract infection (LRTI). Methods This was a post-hoc analysis of a randomized clinical trial previously conducted among LRTI patients. The ability of PCT, CRP and PCT or CRP combined with clinical symptoms to discriminate between viral and bacterial infection were assessed by portraying receiver operating characteristic (ROC) curves among patients with only a viral or a typical bacterial infection. Results In total, 209 infected patients (viral 69%, bacterial 31%) were included in the study. When using CRP or PCT to discriminate between viral and bacterial LRTI, the optimal cut-off points were 22 mg/L and 0.18 ng/mL, respectively. When the optimal cut-off for CRP (≤ 22 mg/L) or PCT (≤ 0.18 ng/mL) combined with rhinorrhea was used to discriminate viral from bacterial LRTI, the AUCs were 0.81 (95% CI: 0.75–0.87) and 0.80 (95% CI: 0.74–0.86), which was statistically significantly better than when CRP or PCT used alone (p < 0.001). When CRP ≤ 22 mg/L, PCT ≤ 0.18 ng/mL and rhinorrhea were combined, the AUC was 0.86 (95% CI: 0.80–0.91), which was statistically significantly higher than when CRP (≤ 22 mg/L) or PCT (≤ 0.18 ng/mL) was combined with rhinorrhea (p = 0.011 and p = 0.021). Conclusions Either CRP ≤ 22 mg/L or PCT ≤ 0.18 ng/mL combined with rhinorrhea could help distinguish viral from bacterial infections in hospitalized non-ICU adults with LRTI. When rhinorrhea was combined together, discrimination ability was further improved.

scholarly journals 1334. Performance of C-Reactive Protein and Procalcitonin in Immunocompromised Children with SIRS

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S483-S483
Author(s):  
Leila C Posch ◽  
Craig L K Boge ◽  
Jeffrey Gerber ◽  
Julie Fitzgerald ◽  
Scott L Weiss ◽  
...  
Keyword(s):  
Blood Culture ◽  
Bacterial Infection ◽  
Viral Infection ◽  
Bacterial Infections ◽  
Solid Organ ◽  
Cell Transplant ◽  
C Reactive Protein ◽  
Research Support ◽  
Hematopoietic Cell Transplant ◽  
Reactive Protein

Abstract Background Biomarkers (C-reactive protein [CRP], procalcitonin [PCT]) have been used in patients with systemic inflammatory response syndrome (SIRS) to identify those with and without bacterial infection. However, their performance in immunocompromised (IC) children is not well studied. Methods Retrospective chart review of episodes of SIRS in IC children <19 years old admitted to the PICU August 2012–June 2016 with: (a) blood culture, PCT, and CRP obtained within 6 hours of SIRS, (b) no recent SIRS episodes (> 30 days), and (c) no positive blood culture in 2 days preceding SIRS. We defined IC as neutropenia (ANC< 500), solid-organ transplant (SOT), hematopoietic cell transplant (HCT), and other (immunosuppressive medications or primary immunodeficiency). To identify a comparator group, we additionally reviewed a previously published cohort of non-IC children with SIRS (Downes, et al, JPIDS 2018), applying the same inclusion criteria. For each episode (first 48 hours after SIRS), we determined the presence of bacterial infection using NHSN definitions and viral infection as symptoms with positive PCR. We compared biomarkers in IC children with and without bacterial infection, and in IC and non-IC children, using Wilcoxon rank-sum tests. Results We identified 108 SIRS episodes in 94 IC children (neutropenia = 35, SOT = 18, HCT = 22, other = 33) and 278 episodes in 250 non-IC children. Age (P = 0.15) and gender (P = 0.70) were similar among IC and non-IC groups. 41% of episodes in both IC and non-IC children had bacterial infections (P = 0.96). PCT and CRP were significantly higher in IC children with bacterial infection than those without (Figure 1). Biomarkers did not differ significantly among episodes in IC and non-IC children with bacterial infection; however, among episodes without bacterial infection, biomarkers were higher in IC than non-IC children (Table 1). Detection of a viral infection did not affect biomarker values in IC or non-IC children when bacterial infection was absent (Table 2). Conclusion In IC children with SIRS, PCT and CRP were higher when bacterial infection was present. Meanwhile, in the subset of non-bacterial SIRS episodes, biomarkers were higher in IC compared with non-IC children. PCT and CRP may be valuable markers to discriminate bacterial from non-bacterial causes of SIRS in IC children. Disclosures Kevin J. Downes, MD, Merck: Grant/Research Support, Research Grant; Pfizer: Grant/Research Support.

scholarly journals Usefulness of presepsin as diagnostic and prognostic marker of sepsis in daily clinical practice

2019 ◽  
Vol 13 (11) ◽  
pp. 1038-1044 ◽  
Author(s):  
Matjaz Jereb ◽  
Matej Mavric ◽  
Miha Skvarc ◽  
Alja Drobnic ◽  
Spela Dolenc ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Prospective Observational Study ◽  
Control Group ◽  
C Reactive Protein ◽  
Gram Positive Bacteria ◽  
Reactive Protein ◽  
Appropriate Treatment ◽  
The Mean ◽  
Systemic Bacterial Infection

Introduction: Sepsis represents a major cause of morbidity and mortality in critically ill patients. Early diagnosis and appropriate treatment have a crucial influence on survival. The aim of this study was to evaluate the diagnostic and prognostic role of presepsin (sCD14) in patients with sepsis. Methodology: Fifty-four consecutive adult patients with sepsis and 26 patients with aseptic meningitis as a control group were included in this prospective observational study. In all patients included in the study, levels of C-reactive protein (CRP), presepsin, lactate, and a count of leukocytes and neutrophils were determined on admission. In those with suspected bacterial infection, two separate blood cultures were obtained and procalcitonin (PCT) concentration was detected. Plasma presepsin and PCT concentrations in septic group patients were followed on days 2, 3 and 7 after enrollment. Results: The median presepsin serum concentration in patients with sepsis was 1614 pg/mL and in the control group it was 203 pg/mL (p < 0.001). Presepsin levels in patients with septic shock were higher than in sepsis patients (p < 0.014). The mean presepsin concentrations were higher in deceased than in surviving patients (p = 0.009). The trend of changes in presepsin concentrations in deceased patients was significantly different than in the surviving patients (p = 0.018). There were no statistically significant differences in the concentration of presepsin or other biomarkers in patients with Gram negative or Gram positive bacteria. Conclusions: Presepsin may be used as a diagnostic marker of systemic bacterial infection and can predict the severity and outcome of sepsis.

scholarly journals DIAGNOSTIC OF C-REACTIVE PROTEIN IN FEBRILE CHILDREN

2018 ◽  
Vol 18 (2) ◽  
pp. 117
Author(s):  
Johanis Johanis ◽  
Aryati Aryati ◽  
Dominicus Husada ◽  
Djoko Marsudi ◽  
M. Y. Probohoesodo
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Area Under Curve ◽  
Acute Phase Protein ◽  
C Reactive Protein ◽  
Optimal Test ◽  
Data Set ◽  
Reactive Protein ◽  
Phase Protein ◽  
Outcome Result

The measurement of C-reactive protein (CRP), an acute-phase protein synthesized by hepatocytes, is valuable to distinguish bacterialinfection from non-bacterial infections in children. The aim of this study is to know the diagnostic properties of quantitative CRPassociated with clinically bacterial and non-bacterial infection in febrile children. Febrile children which was studied were presentingin the Paediatric Emergency Department, their ages were up to 12 years, with axillary’s temperature ≥38.5° C, and the clinicallyundetectable source of fever were enrolled in this consecutive study from September, 2009, up to August, 2010. Informed consent wasobtained for the use of CRP evaluation. The CRP concentration was measured with immunoturbidimetry method (Pure auto S CRP latex(SS-type), Sekisui Medical Co., Ltd) and an auto photometer TMS 1024i. The main outcome result was the presence of the laboratoryexamination results, blood culture, or radio graphically. The receiver operator characteristic (ROC) curve was modelled for quantitativeCRP to identify the optimal test value. Eighty-six patients were enrolled in this study. Forty-one (47.6%) had bacterial infection and 45(52.3%) had non-bacterial infection. The CRP concentration was significantly different between the two groups (p=0.003). The ROCanalysis demonstrated an area under curve (AUC) 0.689, standard error (SE) 0.059, and 95% confidence interval (CI): 0.573-0.805.The optimal cut-off point for CRP in this data set at 5 mg/L, achieved sensitivity of 0.61, specificity of 0.71, and likelihood ratio 2.11(Kappa 0.003, McNemar 0.711) for the detection of bacterial infection in this population. The Quantitative CRP concentration is avaluable laboratory test for the evaluation of febrile children who are at risk of bacterial infection.

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