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 ◽  
...  

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.

2017 ◽  
pp. 81-85
Author(s):  
G. L. IGNATOVA ◽  
V. N. ANTONOV

The article discusses the problem of COPD combined with CAD, determination of inflammatory markers and the prognostic BODE, DOSE and ADO indices. The aim of the study was to evaluate the effect of PCV13 immunization on clinical and functional manifestations of systemic inflammation in patients with COPD and CAD, as well as the relationship with the prognostic markers. Material and methods: The study included 36 male patients with COPD and 36 patients with COPD and CAD, FC II-III stable angina who were treated at Regional Clinical Hospital _4 in Chelyabinsk during the period 2015--2016. Conclusions: 1. Patients with COPD combined with CAD had statistically significant clinical and functional disorders manifested by an increase in the degree of dyspnea and reduction in FEV1. 2. In patients with COPD concomitant with CAD, against the background of the comorbidities, the levels of systemic inflammation markers — C-reactive protein, fibrinogen and procalcitonin — were more overt than in patients only with COPD. 3. Monitoring changes in procalcitonin levels could be used as an additional highly informative method for estimating the probability of the presence of bacterial inflammation and effectiveness of therapy. 4. The prognostic BODE, DOSE and ADO indices tend to decrease unidirectionally under the impact of vaccination with pneumococcal conjugate vaccine. 5. PCV13 can reduce the level of systemic inflammation within 1 year after its application.


2021 ◽  
Vol 100 (6) ◽  
pp. 162-167
Author(s):  
L.N. Mazankova ◽  
◽  
O.V. Molochkova ◽  
O.В. Kovalev ◽  
O.V. Shamsheva ◽  
...  

During the COVID-19 pandemic, it is necessary to be wary of the development of pediatric multisystem inflammatory syndrome in children (PMIS) who have had a COVID-19 and had antibodies to the SARS-CoV-2 virus. The aim of this work is to describe two clinical cases in children with antibodies to SARS-CoV-2 against the background of yersiniosis in a 12-year-old child and salmonellosis in a 3-year-old child, which proceeded with a pronounced inflammatory reaction and required a differential diagnosis with multisystem inflammatory syndrome. These bacterial infections proceeded with severe intoxication and fever, had a polymorphic clinical picture with exanthema syndrome, conjunctivitis/scleritis, swelling of the palms/feet, diarrhea and toxic kidney damage, with a pronounced systemic inflammatory reaction – high leukocytosis with neutrophilia and lymphopenia, a significant increase in C-reactive protein, procalcitonin, hypercoagulability (increased fibrinogen, D-dimer). Etiotropic antibiotic therapy led to recovery in both cases. Conclusions: During the COVID-19 pandemic, if antibodies to the SARS-CoV-2 virus are detected in children in the presence of signs of systemic inflammation and corresponding symptoms, the alertness of doctors and a timely comprehensive examination are necessary to exclude bacterial infections, also characterized by signs of systemic inflammation, for the purpose of differential diagnosis of PMIS.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Hee Joung Choi ◽  
Tae Chan Kwon

Purpose: Procalcitonin (PCT) is one of acute phase reactants such as C-reactive protein (CRP), and is likely to elevate in systemic inflammation, especially bacterial infection. As we know, the CRP level rise in the patients with high fever including Kawasaki disease (KD) and bacterial infection. So we investigated the clinical usefulness of serum PCT level in Kawasaki disease (KD), which is a systemic inflammation caused by vasculitis. Method: From August 2013 to June 2014, a total 336 patients were studied serum PCT level during hospitalization. We enrolled 41 patients of KD, 83 patients with viral infection, and 21 patients with bacterial infection. Result: The patients with KD had significantly higher mean age (24.4±18.1 months), mean body weight (12.1±3.9 Kg), and mean duration of fever prior to admission (4.4±1.8 days) than other patients (p<0.05). The serum PCT level, white blood cell (WBC) and platelet count, neutrophil proportion, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly higher in KD patients than viral infection patients (p<0.05). Although not statistically significant, the serum PCT level was lower in KD patients than bacterial infection patients, whereas the CRP was higher in KD patients than bacterial infection patients. No significant difference in serum PCT level was showed between complete KD patients and incomplete KD patients. Also there was no significant difference in serum PCT level between responders to an initial intravenous immunoglobulin treatment and nonresponders. Conclusion: Serum PCT level may help to differentiate KD from viral infection, but we did not find a significant difference in PCT level between KD and bacterial infection. And the utility of PCT level as clinical marker in KD may be limited.


2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Michal Holub ◽  
David A. Lawrence ◽  
Nancy Andersen ◽  
Alžběta Davidová ◽  
Ondřej Beran ◽  
...  

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.


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.


Infection ◽  
2021 ◽  
Author(s):  
Isabell Pink ◽  
David Raupach ◽  
Jan Fuge ◽  
Ralf-Peter Vonberg ◽  
Marius M. Hoeper ◽  
...  

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.


2017 ◽  
Vol 89 (11) ◽  
pp. 105-110
Author(s):  
N L Ryabkova ◽  
N N Vezikova

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.


2019 ◽  
Vol 16 (41) ◽  
pp. 401-404
Author(s):  
Deepak Mishra ◽  
Amit Kumar Das ◽  
Ram Hari Chapagain ◽  
Nitu Kumari Jha ◽  
Ganesh Kumar Rai

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.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Emmanuel Bottieau ◽  
Deby Mukendi ◽  
Jean-Roger Lilo Kalo ◽  
Pascal Lutumba ◽  
Barbara Barbé ◽  
...  

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.


Sign in / Sign up

Export Citation Format

Share Document