scholarly journals Biomarkers for Sepsis

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Cesar Henriquez-Camacho ◽  
Juan Losa

Bloodstream infections are a major concern because of high levels of antibiotic consumption and of the increasing prevalence of antimicrobial resistance. Bacteraemia is identified in a small percentage of patients with signs and symptoms of sepsis. Biomarkers are widely used in clinical practice and they are useful for monitoring the infectious process. Procalcitonin (PCT) and C-reactive protein (CRP) have been most widely used, but even these have limited abilities to distinguish sepsis from other inflammatory conditions or to predict outcome. PCT has been used to guide empirical antibacterial therapy in patients with respiratory infections and help to determine if antibacterial therapy can be stopped. New biomarkers such as those in this review will discuss the major types of biomarkers of bloodstream infections/sepsis, including soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), soluble urokinase-type plasminogen receptor (suPAR), proadrenomedullin (ProADM), and presepsin.

BJGP Open ◽  
2020 ◽  
pp. bjgpopen20X101136
Author(s):  
Jesper Lykkegaard ◽  
Jonas Kanstrup Olsen ◽  
Rikke Vognbjerg Sydenham ◽  
Malene Hansen

Background: General practitioners (GPs) can use C-reactive protein (CRP) point-of-care test to assist when deciding whether to prescribe antibiotics for patients with acute respiratory tract infections (RTIs). Aim: To estimate which CRP cut-off levels Danish GPs use to guide antibiotic prescribing for patients presenting with different signs and symptoms of RTIs. Design and setting: Cross-sectional study. General practice in Denmark. Methods: During winter 2017 and 2018, 143 GPs and their staff registered consecutive patients with symptoms of an RTI according to the Audit Project Odense method. CRP cut-offs were estimated as the lowest level at which half of the patients were prescribed an antibiotic. Results: In total, 7,813 patients were diagnosed with an RTI of whom 4,617 (59%) had a CRP test performed. At least 25% of the patients were prescribed an antibiotic when the CRP level was above 20 mg/L, at least 50% when CRP was above 40 mg/L, and at least 75% when CRP was above 50 mg/L. Lower thresholds were identified for patients aged 65 years and those presenting with a fever, poor general appearance, dyspnoea, abnormal lung auscultation or ear/facial pain - and if the duration of symptoms was either short (≤1 day) or long (>14 days). Conclusion: More than half of patients presenting to Danish general practice with symptoms of an RTI have a CRP test performed. At CRP-levels above 40 mg/L the majority of patients have an antibiotic prescribed.


2021 ◽  
Vol 19 (1) ◽  
pp. 31-34
Author(s):  
Pradeep Chandra Sharma ◽  

Background: Acute appendicitis is a common surgical condition and the most common cause of acute surgical abdomen. Commonly used tests for diagnosis of acute appendicitis were WBC, CRP ESR and procalcitonin (PCT) levels. In present study we correlated the serum levels of CRP with the histopathology of the removed appendix, to study predictive value of serum C- reactive protein in diagnosis of acute appendicitis. Material and Methods:Present study was conducted in patients with possibility of acute appendicitis, underwent appendicectomy. The histopathology report was considered as the final diagnosis. CRP more than 6 mg/dl was considered to be positive. Results: In present study total 88 patients were included. Male to female ratio was 1.4:1, most common age group was 21-30 years (35.23%) followed by 31-40 years (27.27%). Abdominal pain (92.05%), McBurney tenderness (80.68%), vomiting (76.14%), rebound tenderness (67.05%) and fever (55.68%) were common signs and symptoms noted in present study. On histopathology examination, inflammed appendix (51.14%) was most common finding, others were gangrenous appendix (23.86%), perforated appendix (5.68%) and normal appendix (19.32%). In present study diagnostic efficacy of serum CRP was sensitivity (80%), specificity (84.62%), positive predictive value (96.77%), negative predictive value (42.31%), diagnostic accuracy (80.68%). Conclusion. Serum CRP estimation is useful adjunct in diagnosis of acute appendicitis along with clinical diagnosis. Serum CRP value should be interpreted in combination with clinical findings.


2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Abbas Al Mutair ◽  
Saad Alhumaid ◽  
Waad N. Alhuqbani ◽  
Abdul Rehman Z. Zaidi ◽  
Safug Alkoraisi ◽  
...  

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) emerged from China in December 2019 and has presented as a substantial and serious threat to global health. We aimed to describe the clinical, epidemiological, and laboratory findings of patients in Saudi Arabia infected with SARS-CoV-2 to direct us in helping prevent and treat coronavirus disease 2019 (COVID-19) across Saudi Arabia and around the world. Materials and methods Clinical, epidemiological, laboratory, and radiological characteristics, treatment, and outcomes of pediatric and adult patients in five hospitals in Riyadh, Saudi Arabia, were surveyed in this study. Results 401 patients (mean age 38.16 ± 13.43 years) were identified to be SARS-CoV-2 positive and 80% of cases were male. 160 patients had moderate severity and 241 were mild in severity. The most common signs and symptoms at presentation were cough, fever, fatigue, and shortness of breath. Neutrophil and lymphocyte counts, aspartate aminotransferase, C-reactive protein, and ferritin were higher in the COVID-19 moderate severity patient group. Mild severity patients spent a shorter duration hospitalized and had slightly higher percentages of abnormal CT scans and X-ray imaging. Conclusions This study provides an understanding of the features of non-ICU COVID-19 patients in Saudi Arabia. Further national collaborative studies are needed to streamline screening and treatment procedures for COVID-19.


2009 ◽  
Vol 37 (3) ◽  
pp. 450-456 ◽  
Author(s):  
K. M. Ho ◽  
S. C. Towler

Diagnosis of bloodstream infections in critically ill patients is difficult. This case control study involved a total of 22 patients with confirmed bloodstream infections and 44 concurrent controls from an intensive care unit in Western Australia. We aimed to assess whether eosinopenia and C-reactive protein are useful markers of bloodstream infections in critically ill patients. The patients with bloodstream infections had a more severe disease and a longer length of intensive care unit (10.7 vs 4.0 days, P=0.001) and hospital stay (40.9 vs 17.9 days, P=0.015) than the controls. Univariate analyses showed that C-reactive protein (area under the receiver operating characteristic curve 0.847, 95% confidence internal (CI) 0.721 to 0.973), eosinophil counts (area under the receiver operating characteristic curve 0.849, 95% CI 0.738 to 0.961) and fibrinogen concentrations (area under the receiver operating characteristic curve 0.730, 95% CI 0.578 to 0.882) were significant markers of bloodstream infections. C-reactive protein concentration was, however, the only significant predictor in the multivariate analysis (odds ratio 1.21 per 10 mgH increment, 95% CI 1.01 to 1.39, P=0.007). C-reactive protein concentration appears to be a better marker of bloodstream infections than eosinopenia in critically ill patients. A large prospective cohort study is needed to assess whether eosinopenia is useful in addition to C-reactive protein concentrations as a marker of bloodstream infections.


2020 ◽  
Vol 7 (1) ◽  
pp. e000386
Author(s):  
George Nye ◽  
Francois-Xavier Liebel ◽  
Tom Harcourt-Brown

ObjectivesC-reactive protein (CRP) is an acute phase protein used in multiple canine inflammatory conditions including steroid responsive meningitis-arteritis, immune-mediated polyarthritis and bronchopneumonia. The aim of this study was to assess whether serum CRP is elevated in cases of diskospondylitis.MethodsMedical records from 2010 to 2019 were searched to identify dogs diagnosed with diskospondylitis based on findings consistent on CT or MRI and with CRP tested.ResultsA total of 16 dogs met the inclusion criteria. All cases had back pain. Fourteen cases had elevated CRP, with a median value of 100.7 mg/l (reference range for CRP values: 0–10 mg/l), 12 were pyrexic and six had leucocytosis. The two dogs with normal CRP were normothermic and did not have leucocytosis. CRP was measured four to six weeks into antimicrobial treatment in eight of 14 dogs and was normal in all cases. One dog developed a suspected bacterial empyema diagnosed on MRI; this occurred two weeks after antibiotic treatment was discontinued based on a normal CRP level at follow-up.ConclusionsSerum CRP is elevated in cases of diskospondylitis and may be clinically more useful to screen dogs with back pain than pyrexia or leucocytosis alone. Further long-term clinical evaluation in a prospective study is needed to assess its use as a treatment monitoring tool and in decision making.


Sign in / Sign up

Export Citation Format

Share Document