TY - JOUR
T1 - The potential benefit of a second C-reactive protein measurement in patients with gram-negative bacteraemia presenting to the emergency medicine department
AU - Levinson, Tal
AU - Tamir, Natalie
AU - Shenhar-Tsarfaty, Shani
AU - Paran, Yael
AU - Zeltzer, David
AU - Shapira, Itzhak
AU - Halpern, Pinchas
AU - Meilik, Ahuva
AU - Raykhshtat, Eli
AU - Goldiner, Ilana
AU - Adler, Amos
AU - Berliner, Shlomo
AU - Rogowski, Ori
AU - Wasserman, Asaf
N1 - Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/10/2
Y1 - 2020/10/2
N2 - 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 <30 mg/L and 460 patients with 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.
AB - 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 <30 mg/L and 460 patients with 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.
KW - C-reactive protein
KW - cytokines
KW - department of emergency medicine
KW - gram-negative bacteraemia
KW - inflammation
UR - http://www.scopus.com/inward/record.url?scp=85088555928&partnerID=8YFLogxK
U2 - 10.1080/1354750X.2020.1797878
DO - 10.1080/1354750X.2020.1797878
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C2 - 32715769
AN - SCOPUS:85088555928
SN - 1354-750X
VL - 25
SP - 533
EP - 538
JO - Biomarkers
JF - Biomarkers
IS - 7
ER -