The potential benefit of a second C-reactive protein measurement in patients with gram-negative bacteraemia presenting to the emergency medicine department

被引:11
|
作者
Levinson, Tal [1 ,2 ,3 ]
Tamir, Natalie [1 ,3 ]
Shenhar-Tsarfaty, Shani [1 ,3 ]
Paran, Yael [2 ,3 ]
Zeltzer, David [1 ,3 ]
Shapira, Itzhak [1 ,3 ]
Halpern, Pinchas [3 ,4 ]
Meilik, Ahuva [3 ,5 ]
Raykhshtat, Eli [3 ,5 ]
Goldiner, Ilana [3 ,6 ]
Adler, Amos [3 ,7 ]
Berliner, Shlomo [1 ,3 ]
Rogowski, Ori [1 ,3 ]
Wasserman, Asaf [1 ,2 ,3 ]
机构
[1] Tel Aviv Sourasky Med Ctr, Dept Internal Med CD&E, Tel Aviv, Israel
[2] Tel Aviv Sourasky Med Ctr, Infect Dis Unit, Tel Aviv, Israel
[3] Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel
[4] Tel Aviv Sourasky Med Ctr, Dept Emergency Med, Tel Aviv, Israel
[5] Tel Aviv Sourasky Med Ctr, Data Sci & Qual Div, Tel Aviv, Israel
[6] Tel Aviv Sourasky Med Ctr, Clin Lab Serv, Tel Aviv, Israel
[7] Tel Aviv Sourasky Med Ctr, Clin Microbiol Lab, Tel Aviv, Israel
关键词
C-reactive protein; cytokines; department of emergency medicine; gram-negative bacteraemia; inflammation; INFLAMMATION; PREDICTION; BIOMARKERS; SEPSIS;
D O I
10.1080/1354750X.2020.1797878
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
Background Low C-reactive protein in acute bacterial infections could convey the erroneous impression of a mild infection. We focussed on gram-negative bacteraemia, a phenomenon frequently seen at the emergency room. Methods Of 2200 patients with gram-negative bacteraemia, 460 patients with first C-reactive protein 187 mg/L were reviewed. Following exclusions, we finally investigated 229 and 289 patients with low and high C-reactive protein concentrations, respectively. Results The cohort was divided into low and high C-reactive protein groups. Median first C-reactive protein was 13.6 and 219.9 mg/L, respectively (interquartile range 6.4-21.6 and 195-270.1). Compared to patients with first high C-reactive protein, patients with first low C-reactive protein concentrations had a significant five-fold higher C-reactive protein level with their second test. Conclusions Patients with gram-negative bacteraemia can present with C-reactive protein within the range of apparently healthy individuals. A second C-reactive protein might help to avoid an erroneous decision regarding the severity of the infection.
引用
收藏
页码:533 / 538
页数:6
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