Utility of Blood Markers in Early Prediction of Bacteraemia in Acute Febrile Paediatric Patients – An Observational Cohort Study in a Tertiary Care Hospital of North India

2021 ◽  
Vol 8 (28) ◽  
pp. 2526-2531
Author(s):  
Rabindra Bhunia ◽  
Bindu T. Nair ◽  
Vandana Negi
Keyword(s):  
Tertiary Care Hospital ◽  
Leukocyte Count ◽  
Tertiary Care ◽  
North India ◽  
Total Leukocyte Count ◽  
Care Hospital ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Neutrophil Percentage ◽  
Observational Cohort

BACKGROUND Bacteraemia is a common cause of children presenting to the paediatric emergency with acute febrile illness. Blood cultures remain the gold standard for detection of bacteraemia but the positivity is low and also takes time to show positive results. A rapid and reliable biomarker like procalcitonin (PCT), C-reactive protein (CRP), total leucocyte count (TLC), and neutrophil-lymphocyte count ratio (NLCR) can be used to identify febrile children with greater risk for bacteraemia or serious bacterial infections. This would be very helpful to start early treatment of bacteraemia with antibiotics. METHODS The study was an observational cohort study conducted in the Department of Paediatrics of a tertiary care hospital in North India in children between age group 6 months to 12 years presenting with fever of > 100.4° F for 2 - 7 days. Blood samples were sent for PCT, CRP, TLC, NLCR and blood cultures. RESULTS The most sensitive biomarker was total leukocyte count (47.36 %) followed by the neutrophil percentage (26.32 %), C-reactive protein (21.05 %), and procalcitonin (15.79 %). The most specific biomarker was procalcitonin (75.14 %) followed by C-reactive protein (58.56 %), neutrophil percentage (22.65 %) and total leukocyte count (11.05 %). The only biomarker that was statistically significant between the bacteraemia and non-bacteraemia group in the present study was total leukocyte count (P – value < 0.05). CONCLUSIONS The sensitivity and specificity of each single biomarker is low and hence these cannot be used singly to predict bacteraemia. There should be a combination of biomarkers with adequate sensitivity and specificity that can be used to create an algorithm to aid in diagnosis and prognostication. KEYWORDS Procalcitonin, C-Reactive Protein, Blood Culture, Acute Febrile Patient

scholarly journals Association between C reactive protein and obesity: a study in a tertiary care hospital

2019 ◽  
Vol 6 (5) ◽  
pp. 1535
Author(s):  
Lavanya Mandli
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Cardiovascular Diseases ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Obese Patients ◽  
Elevated Blood ◽  
C Reactive Protein ◽  
Reactive Protein

Background: Obesity and dyslipidemia, especially in children and adolescents coupled with impaired blood glucose metabolism and elevated blood pressure may result in atherosclerosis in the older ages. This study was conducted to assess the association between high levels of CRP with obesity.Methods: Details including height and weight for BMI and serum for C reactive protein estimation was collected for all 134 patients.Results: 60.4% were females and 49.6% were males. Among the obese patients, clinically raised CRP levels was observed in 29.2% and elevated CRP levels in 45.8% levels, while in overweight patients, 21.4% had clinically raised CRP and 46.4% has elevated CRP levels. In normal BMI patients, elevated CRP was seen in 22% and clinically raised in 1.9%.Conclusion: Detection of CRP levels in overweight and obese patients is imperative in the early stages itself to prevent cardiovascular diseases.

scholarly journals C-reactive Protein to Albumin Ratio among Patients Admitted to Intensive Care Unit of a Tertiary Care Hospital: A Descriptive Crosssectional Study

2021 ◽  
Vol 59 (244) ◽  
pp. 1247-1251
Author(s):  
Pratiksha Gyawali ◽  
Himal Shrestha ◽  
Vivek Pant ◽  
Prabodh Risal ◽  
Sharad Gautam
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Binary Data ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Common Finding ◽  
Care Hospital ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein

Introduction: Sepsis is the most common cause of mortality among patients admitted to intensive care unit. There is emerging evidence on the role of C-reactive protein to albumin ratio (C-reactive protein/Albumin) in predicting outcomes in patients with critical illness and sepsis, admitted to intensive care unit. We aimed to find out the median value of C-reactive protein/Albumin ratio among patients admitted to intensive care unit of a tertiary care hospital. Methods: We conducted a descriptive cross-sectional study of 110 critically ill patients (>18 years old) admitted to intensive care unit of Dhulikhel Hospital from April, 2014 to June, 2016. The ethical approval (Reference number.51/16) was obtained from Institutional Review Committee at Kathmandu University School of Medical Sciences. C-reactive protein/albumin ratio was calculated from records of patients admitted to the intensive care unit. Convenience sampling was done. Data were entered into Microsoft Excel and analysed using Statistical Package for Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequencies and percentages for binary data. Results: Among 110 patients admitted to the intensive care unit, the median value of C-reactive protein/Albumin ratio was found to be 3.4 (Interquartile range: 3.1-4.5). Conclusions: Our study showed higher median C-reactive protein /Albumin similar to toher studies. Sepsis is a common finding among patients admitted to intensive care unit. Monitoring of C-reactive protein/albumin level in a patient admitted to intensive care unit could be useful for stratifying patients with a high risk of developing sepsis.

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