scholarly journals Testing applicability of international guidelines in treatment of sepsis

2014 ◽  
Vol 67 (suppl. 2) ◽  
pp. 24-30
Author(s):  
Vedrana Petric ◽  
Sandra Mikic ◽  
Sinisa Sevic ◽  
Danijela Stankovic-Baricak ◽  
Nevena Drljevic ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Clinical Experience ◽  
Bacterial Infections ◽  
Test Results ◽  
Clinical Protocols ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
International Guidelines ◽  
Mean Values ◽  
Reactive Protein

Introduction. The Department of Infectious Diseases adopted new internal clinical protocols for initial adequate antimicrobial therapy of bacterial infections in January, 2013. Protocols were made up on the basis of European (British National Formulary) and the American (Sanford) guidelines for treatment of bacterial infections. The aim of our study was to investigate the efficiency of new clinical protocols based on international guidelines in treatment of bacteria induced sepsis and to compare it with the efficiency of the existing guidelines, which are based on the use of antibiotics according to clinical experience of the doctors. Material and Methods. The study included 109 patients diagnosed with bacteria-induced sepsis, who were treated at the Department of Infectious Diseases in the period from 1 January, 2012 to 31 December, 2013. Data were collected from the medical records. The patients were divided into two groups. The first group included 54 patients diagnosed with sepsis who were treated empirically. The second group consisted of 55 patients treated according to the new internal protocols. The efficiency of treatment in both groups of patients was monitored by laboratory findings (leukocyte count, C-reactive protein, fibrinogen, sedimentation, procalcitonin), and temperatures, measured on the first and seventh day of hospitalization. For statistical analysis, we used the ?2 test. Results. After the applied treatment, there was a statistically significant decrease in the mean values of C-reactive protein P and procalcitonin on the seventh day of treatment in both groups of patients. The most frequently applied therapy was triple antibiotic therapy - ceftriaxone, ciprofloxacin and metronidazole, in both groups. Conclusion. Treatment of bacteria-induced sepsis according to internationally accepted protocols for treatment of bacterial infections is as effective as treatment of sepsis according to the clinical experience of doctors.

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 Contribution of Rapid Influenza Antigen Test to Management of Febrile Young Infants without a Focus

2021 ◽  
Vol 24 (11) ◽  
pp. 822-827
Author(s):  
Aysun Tekeli ◽  
Ayla Akca Çağlar ◽  
İlknur Bodur ◽  
Betül Öztürk ◽  
Nilden Tuygun ◽  
...  
Keyword(s):  
Lumbar Puncture ◽  
Patient Management ◽  
Pediatric Emergency ◽  
Test Results ◽  
Antigen Test ◽  
Laboratory Findings ◽  
Mean Values ◽  
Reactive Protein ◽  
Young Infants ◽  
Training And Research

Background: The aim of this study was to evaluate the application of the rapid influenza antigen test and the contribution of the test result to patient management in febrile infants aged 29‒90 days. Methods: The medical records of febrile infants without a focus who presented during influenza seasons from 2017‒2019 were analyzed retrospectively. The study was carried out in the Department of Pediatric Emergency, Dr. Sami Ulus Maternity and Children’s Training and Research Hospital. The demographic characteristics, clinical and laboratory findings, and management of the patients were examined. The patients were divided into two groups as ‘with’ and ‘without’ testing based on whether a rapid influenza antigen test was performed or not. Test results were categorized as positive or negative. Serious bacterial infection (SBI) risk and patient management were evaluated according to test results. Results: A total of 173 patients (110 males/63 females) were evaluated. The influenza test was performed in 94 (54.3%) patients, and 31.9% were positive. SBI was present in 8.7% of all patients. The mean values of white blood cell (WBC), absolute neutrophil, platelet count, C-reactive protein (CRP) and, lumbar puncture, hospitalization, and initiation of antibiotic therapy were significantly lower in the positive group compared to the negative and without testing groups (P<0.05). Conclusion: This study showed that using the influenza test in the emergency department in young febrile infants significantly reduced the use of antibiotics, hospitalization and the implementation of invasive procedures such as lumbar puncture, and the risk of SBI was not increased.

scholarly journals Clinical Characteristics and Laboratory Biomarkers Changes in COVID-19 Patients Requiring or not Intensive or Sub-Intensive Care: A Comparative Study

2020 ◽  
Author(s):  
Anna Maria Cattelan ◽  
Eugenia Di Meco ◽  
Marco Trevenzoli ◽  
Alessia Frater ◽  
Anna Ferrari ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Neutrophil Count ◽  
Primary Outcome ◽  
Clinical Laboratory ◽  
Liver Function Tests ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Group 2 ◽  
Group 1

Abstract BackgroundIdentifying risk factors for severe novel-coronavirus disease (COVID-19) is essential to ascertain which patients may benefit from advanced supportive care. The study aims to give a comparative description of COVID-19 patients who were admitted or not to the intensive (ICU) or sub-intensive cares units (SICU). MethodsThis observational study of prospectively collected data included all COVID-19 patients primarily admitted to the Infectious Diseases department of Padua between February 22 and May 20, 2020. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of ICU and/or SICU admission. Results 303 patients were included. Median age was 62 years (IQR:50-74), 60.1% were male. 234 patients were managed in the Infectious Diseases ward (Group 1) and 69 patients (22,8%) met the primary outcome (Group 2). The mortality rate was 6.8%. Group 2 were more likely to be men, had a higher mortality (14,5%vs3,8%, p<0,01) and had more hypertension (72,4vs 44%,p<0,01) and diabetes (31,9vs21%,p=0,04). Chest X-ray at admission was positive in 63,2% and Group 2 were more likely to develop pathological findings during the hospitalization (72,7%vs17,2%,p<0,01). Group 2 presented at admission a higher neutrophil count, aspartate-transaminase and C-reactive-protein. At the 3° measurement, differences were found for white blood cell and neutrophil count, liver function tests and C-reactive-protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20vs35days,p<0,01). ConclusionsThe presence of comorbidities and the persistent observation of slightly abnormal laboratory findings should be regarded as predisposing factors for disease severity and clinical worsening.

scholarly journals Serum C-Reactive Protein and Procalcitonin Kinetics in Patients Undergoing Elective Total Hip Arthroplasty

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Sandra Battistelli ◽  
Mattia Fortina ◽  
Serafino Carta ◽  
Roberto Guerranti ◽  
Francesco Nobile ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bacterial Infections ◽  
Periprosthetic Infection ◽  
C Reactive Protein ◽  
Mean Values ◽  
Total Hip ◽  
Reactive Protein ◽  
Orthopaedic Patients ◽  
Serum Crp

Background. The sensitivity and the specificity of different methods to detect periprosthetic infection have been questioned. The current study aimed to investigate the kinetics of C-reactive protein (CRP) and procalcitonin (PCT) in patients undergoing uncomplicated elective total hip arthroplasty (THA), to provide a better interpretation of their levels in noninfectious inflammatory reaction.Methods. A total of 51 patients were included. Serum CRP and PCT concentrations were obtained before surgery, on the 1st, 3rd, and 7th postoperative days and after discharge on the 14th and 30th days and at 2 years.Results. Both markers were confirmed to increase after surgery. The serum CRP showed a marked increase on the 3rd postoperative day while the peak of serum PCT was earlier, even if much lower, on the first day. Then, they declined slowly approaching the baseline values by the second postoperative week. PCT mean values never exceed concentrations typically related to bacterial infections.Conclusions. CRP is very sensitive to inflammation. It could be the routine screening test in the follow-up of THA orthopaedic patients, but it should be complemented by PCT when there is the clinical suspicion of periprosthetic infection.

Value of measuring serum procalcitonin, C-reactive protein, and mannan antigens to distinguish fungal from bacterial infections

2005 ◽  
Vol 24 (4) ◽  
pp. 272-275 ◽  
Author(s):  
G. L. Petrikkos ◽  
S. A. Christofilopoulou ◽  
N. K. Tentolouris ◽  
E. A. Charvalos ◽  
C. J. Kosmidis ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
C Reactive Protein ◽  
Reactive Protein

C-Reactive Protein as A Fungal Infection Marker in Acute Leukemia Patients

2021 ◽  
Vol 27 (2) ◽  
pp. 212
Author(s):  
Brigitte Rina Aninda Sidharta ◽  
JB. Suparyatmo ◽  
Avanti Fitri Astuti
Keyword(s):  
Acute Leukemia ◽  
Predictive Value ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Lymphoblastic Leukemia ◽  
Negative Likelihood Ratio ◽  
Receiver Operating Curve ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Reactive Protein

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity andmortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increasesin bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determineC-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values ofCRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Departmentof Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusioncriteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patientswith liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years.Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in themaintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line(22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positiveculture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-offvalue of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivityof 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, PositiveLikelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used asa screening marker for fungal infections in patients with acute leukemia.

scholarly journals THE OCCURRENCE DURING ACUTE INFECTIONS OF A PROTEIN NOT NORMALLY PRESENT IN THE BLOOD

1947 ◽  
Vol 85 (5) ◽  
pp. 491-498 ◽  
Author(s):  
Maclyn McCarty
Keyword(s):  
Infectious Diseases ◽  
Early Phase ◽  
Serum Proteins ◽  
Protein A ◽  
Normal Serum ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Acute Infections

A procedure is described for the isolation and crystallization from human serous fluids of the C-reactive protein, a substance which appears in the blood especially in the early phase of certain acute infectious diseases. Immunological studies confirm earlier work in showing that the protein is highly antigenic and serologically specific, and demonstrate that crystallization of the protein effectively separates it from normal serum proteins.

scholarly journals Kinetics of C-reactive protein, interleukin-6 and -10, and phospholipase A2-II in severely traumatized septic patients

2010 ◽  
Vol 67 (11) ◽  
pp. 893-897 ◽  
Author(s):  
Zeljko Lausevic ◽  
Goran Vukovic ◽  
Biljana Stojimirovic ◽  
Jasna Trbojevic-Stankovic ◽  
Vladimir Resanovic ◽  
...  
Keyword(s):  
Phospholipase A2 ◽  
Injury Severity ◽  
C Reactive Protein ◽  
Surgical Intensive Care ◽  
Septic Complications ◽  
Mean Values ◽  
Protein Levels ◽  
Reactive Protein ◽  
Significant Difference ◽  
Kinetics Of

Background/Aim. Injury-induced anergy is one of the key factors contributing to trauma victims' high susceptibility to sepsis. This group of patients is mostly of young age and it is therefore essential to be able to predict as accurately as possible the development of septic complications, so appropriate treatment could be provided. The aim of this study was to assess kinetics of interleukin (IL) -6 and -10, phospholipase A2- II and C-reactive protein (CRP) in severely traumatized patients and explore the possibilities for early detection of potentially septic patients. Methods. This prospective study included 65 traumatized patients with injury severity score (ISS) > 18, requiring treatment at surgical intensive care units, divided into two groups: 24 patients without sepsis and 41 patients with sepsis. C-reactive protein, IL-6 and -10 and phospholipase A2 group II, were determined within the first 24 hours, and on the second, third and seventh day of hospitalization. Results. Mean values of IL-6 and phospholipase A2-II in the patients with and without sepsis did not show a statistically significant difference on any assessed time points. In the septic patients with ISS 29-35 and > 35 on the days two and seven a statistically significantly lower level of IL-10 was found, compared with those without sepsis and with the same ISS. C-reactive protein levels were significantly higher in septic patients with ISS 18-28 on the first day. On the second, third and seventh day CRP levels were significantly lower in the groups of septic patients with ISS 29-35 and > 35, than in those with the same ISS but without sepsis. Conclusion. Mean levels of CRP on the first day after the injury may be useful predictor of sepsis development in traumatized patients with ISS score 18-28. Mean levels of CRP on the days two, three and seven after the injury may be a useful predictor of sepsis development in traumatized patients with ISS score more than 28. Mean levels of IL-10 on the second and seventh day after the injury may be a useful predictor of sepsis development in traumatized patients with ISS score > 28.

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