Usefulness of plasma C reactive protein ( CRP ) estimation in patients with bacterial sepsis between 1997 2000 there were … (2002 May)
usefulness of plasma C reactive protein ( CRP ) estimation in patients with bacterial sepsis between 1997 2000 there were 30 patients with bacterial sepsis treated at department of infectious diseases of silesian medical university school in bytom . neisseria meningitidis ( 23 . 33 ) , streptococcus pneumoniae ( 20 ) and staphylococcus aureus ( 3 . 33 ) were most frequent etiological factors of the disease . The etiology of sepsis was not revealed in 53 . 34 of cases . clinical state of patients was assessed using SSS and SAPS II score . All subjects were divided into two groups : group I patients with septic syndrome symptoms ( 11 cases ) , group II patients without septic syndrome symptoms ( 19 cases ) . The aim of the study was usefulness of plasma C reactive protein estimation in the course of bacterial sepsis monitoring . plasma CRP concentration was assessed by immunoturbidometric method ( using randox , UK kits ) . blood samples were taken on th 1 . , 4 . and 10 . day of therapy . plasma CRP levels were statistically significantly higher in patients of the group I in samples of the first and the second assay . CRP serum concentration correlated with severity of a patient s clinical state . Type of sepsis s etiological factor did not exert influence on plasma CRP level . In fatal cases high plasma CRP concentration was recorded during the whole time of hospitalization , …

Juvenile dermatomyositis acute recidivism or sepsis ? A 22 year old male with juvenile dermatomyositis presented with fever up to … (1999 Aug)
juvenile dermatomyositis acute recidivism or sepsis ? A 22 year old male with juvenile dermatomyositis presented with fever up to 40 degrees C and acute pain in his right thigh accompanied by muscle weakness , a skin rash and a tender swelling . serum aspartate aminotransferase ( AST ) and aldolase were mildly elevated . C reactive protein ( CRP ) and fibrinogen were markedly increased . The differential white blood cell count revealed relative lymphopenia . radiography showed diffuse calcifications particularly around the thighs and knees of both legs . magnetic resonance imaging ( MRI ) demonstrated inflammatory infiltrates in the right thigh . The lesions were identified as phlegmone by immunoszintigraphy with 99mtc labelled antigranulocyte antibodies . On the 10th day of treatment staphylococcus aureus was cultured from blood . patients with juvenile dermatomyositis and calcinosis may develop bacterial infections of soft tissue which sometimes mimic a disease flare . For differential diagnosis plain radiographs , CT scans and MRI are of limited value . immunoszintigraphy is able to differentiate between infiltrates caused by granulocytes and lymphocytes .

C reactive protein as marker of infection among patients with severe closed trauma background : injury and infection are characterized … (2001 May)
C reactive protein as marker of infection among patients with severe closed trauma background : injury and infection are characterized by the activation of the acute phase proteins response . C reactive protein ( CRP ) , an acute phase protein , has been mentioned as an useful indicator of infection and sepsis in critically ill patients . objective : To study the evolution of serum CRP in patients with severe blunt trauma and to ascertain its ability as a biological marker of infection during the first seven days after injury . methods : We prospectively studied 54 patients with blunt trauma ( injury severity score 16 ) age 14 years and length of the intensive Care Unit ( ICU ) estay 7 days , over a 4 month period . culture proven infections were collected and serum CRP was determinated every day , during the first week after ICU admission . results : twenty eight patients ( 51 . 8 ) developed an infection during the first week , and the median day of diagnosis of infection was day 6 . pneumonia was the most common infection ( 50 ) and Gram negative bacilli ( 63 . 3 ) were the most common microorganisms recovered . serum CRP levels were significantly higher in the infected patients group after day 4 , showing a median value higher than 170 mg / l . based on the receiver operating characteristic ( ROC ) curve analysis , a cutoff value of 109 …

Evaluation of C. (1990 Sep)
evaluation of C . reactive protein values in neonatal sepsis . C . reactive protein ( CRP ) estimations were performed prospectively on 30 consecutive admissions of very low birth weight infants to a regional neonatal intensive care unit . The samples were analysed by a recently described , rapid intralipid agglutination assay and by a reference turbidimetric technique . Two hundred and ninety samples were assayed by both techniques . The intralipid agglutination was positive on two occasions when the reference method found normal levels . No false negative reactions occurred . bacterial micro organisms were isolated on 32 occasions but 19 of the organisms were considered to represent bacterial colonisation or contamination . The CRP remained negative in 17 cases . there were 13 episodes of clinical deterioration associated with positive bacterial cultures . In each of the six infants with severe systemic infections ( septicaemia ( 4 ) , meningitis ( 1 ) , and osteomyelitis ( 1 ) ) , the levels were raised . In five of these infants the CRP was elevated before , or at the time of , the clinical deterioration . The CRP remained normal during seven ( 54 ) of the culture positive events . We believe that the CRP estimations provide additional information in the evaluation of the infant with suspected sepsis . serial measurements are helpful in distinguishing bacterial contamination from invasive infection but are not helpful in predicting infection during the pre clinical phase . The intralipid …

Diagnostic value of C reactive protein test at early onset sepsis in preterm infants. (2006 Mar)
diagnostic value of C reactive protein test at early onset sepsis in preterm infants . bacterial sepsis of preterm infants is an urgent problem of pediatrics , as this population is at high risk for the development of sepsis . The aim of the present investigation was the evaluation of significance of C reactive protein ( CRP ) test for identification of early onset sepsis and assessment of the severity of infectious process . A total of 250 preterm infants , referred to the neonatal intensive care unit of M . iashvili central pediatric clinic at the first hours of life , have been studied during the period of 2002 2005 . level of C reactive protein ( CRP ) was determined at first 24 , 48 and 72 hours from the birth using the method of latex agglutination . Two groups of patients were separated . The first group was comprised of patients diagnosed with sepsis at the first hours of life on the basis of determination of CRP level , which was significantly elevated as compared with norm . quantitative increase of CRP corresponded to the severity of the disease . The diagnosis has been confirmed by positive hemoculture later , after 72 hours . In patients of the second group CRP level corresponded to the normal values and the results of other examinations also indicated the absence of sepsis . In this group treatment with antibiotics was discontinued . The results of investigation allow to conclude that …

C reactive protein as an indicator of resolution of sepsis in the intensive care unit. (1995 Dec)
C reactive protein as an indicator of resolution of sepsis in the intensive care unit . objective : To investigate the value of decreasing plasma C reactive protein ( CRP ) concentrations as an indicator or resolution of microbiologically proven sepsis . design : retrospective analysis of CRP concentrations measured during episodes of microbiologically proven sepsis . A receiver operating characteristic ( ROC ) curve was used to assess the usefulness of CRP as a test for resolution of sepsis . setting : The intensive care unit ( ICU ) of a teaching hospital . patients AND participants : 32 episodes of microbiologically proven sepsis occurring in 18 patients were followed from diagnosis until resolution . measurements AND results : daily routine observations and blood testing were performed prospectively . The daily presence or absence of systemic inflammatory response syndrome ( SIRS ) was prospectively determined according to standard definitions . concentrations of CRP were analysed retrospectively once the patients had left the ICU . A decrease in CRP by 25 or more from the previous day s level was a good indicator of resolution of sepsis , with a sensitivity of 97 , specificity of 95 and predictive value of 97 . In 13 cases ( 46 ) , a decrease in CRP preceded clinical resolution of sepsis ; this was more likely to occur in patients with less severe sepsis than in those with severe sepsis or septic shock . conclusion : daily measurement of CRP is useful …

C reactive protein concentrations during bacteraemia : A comparison between patients with and without liver dysfunction. (2006 Aug)
C reactive protein concentrations during bacteraemia : A comparison between patients with and without liver dysfunction . objective : To evaluate the value of serum C reactive protein ( CRP ) concentrations as a marker of sepsis in patients with biochemical evidence of liver dysfunction . design : A retrospective case control comparison of serum CRP concentrations between patients with and those without liver dysfunction ( prothrombin time over 18 s and serum bilirubin or 20 micromol / l ) during their first episode of bacteraemia . setting : The neurosciences and general adult intensive care units of a university teaching hospital . patients : Any patient from the above settings with a first episode of bacteraemia ( first isolate of pathogenic bacteria from blood cultures ) over a 3 year period . measurements AND results : after exclusions 126 first episodes of bacteraemia were identified , of which 33 were in patients with liver dysfunction . serum CRP concentrations were significantly lower in patients with liver dysfunction ( median 103 mg / l , IQR 29 204 ) than in those without ( 146 mg / l , 74 , 250 ) . conclusions : patients with biochemical evidence of liver disease generate significantly lower serum CRP concentrations during bacteraemia than patients without liver dysfunction . serum CRP concentrations should be interpreted with caution in patients with liver disease to diagnose and monitor bacterial sepsis .

Serial study of C reactive protein in neonatal septicaemia. (1984 Jul)
serial study of C reactive protein in neonatal septicaemia . serial C reactive protein concentrations were assayed by electroimmunoassay in 41 infants . values in most of the non infected infants were below 0 . 3 mg / dl , the lower limit of detection of C reactive protein by electroimmunoassay . eleven of 12 infants with proved sepsis ( positive blood cultures ) had significantly raised concentrations and one infant with recurrent pseudomonas chest infection had a raised C reactive protein concentration . High C reactive protein concentrations were also found in infants with suspected infection . successful treatment was followed by a decrease in the C reactive protein concentration . total white blood cell count was not as appropriate as C reactive protein determination in the early identification of bacterial infection in the newborn .

Responses of opsonic substances to major trauma and sepsis. (1985 Oct)
responses of opsonic substances to major trauma and sepsis . adequate opsonic capability is vital for normal host defense against infection . The presence of complement fraction 3 ( C3 ) indicates both classical and alternative pathways of complement activation , while complement fraction 4 ( C4 ) indicates only classical pathway activation . C reactive protein ( CRP ) functions as an opsonic substance . We measured serum levels of C3 , C4 , and CRP in 32 trauma patients . Six suffered minor injuries and 26 suffered major injuries . nineteen of the major injury patients developed post trauma sepsis . complement levels fell immediately after injury and remained low for approximately 8 days in all patients . CRP levels rose by 12 h , peaked at 48 h , and correlated with the severity of injury and the presence of sepsis . elevated CRP levels after 4 days postinjury indicated the presence of sepsis in all cases . CRP elevations preceded clinical diagnosis by an average of 2 . 4 days . serial measurements of CRP are valuable in monitoring the course of trauma patients and may indicate the presence of septic complications before clinical detection .

Is C reactive protein level useful in differentiating infected from uninfected neonates among those at risk of infection ? objective … (2004 Oct)
Is C reactive protein level useful in differentiating infected from uninfected neonates among those at risk of infection ? objective : To document effects of intrapartum risk factors for early onset sepsis ( EOS ) on CRP levels in neonates and to assess the suitability of this test in diagnosing EOS . design : cohort study . setting : labour and post natal wards in a tertiary level teaching hospital in india . subjects : 250 neonates at risk of developing infection . methods : CRP levels in cord blood and neonatal blood at 24 hrs were estimated using commercial kits . babies were observed for signs of sepsis for at least 48 hours . results : seven ( 2 . 8 percent ) neonates had elevated CRP levels in the cord blood . At 24 hours , 102 ( 40 . 8 percent ) babies had elevated levels . elevated cord CRP levels was significantly associated with rupture of membranes for 24 hours ( p 0 . 04 ) , labour more than 12 hours ( p 0 . 002 ) , and maternal fever ( p 0 . 01 ) . At 24 hours , elevated CRP levels were associated with primiparity ( p 0 . 006 ) , more than three vaginal examinations after membrane rupture ( p 0 . 02 ) , meconium staining of amniotic fluid ( p 0 . 02 ) and amnioinfusion ( p 0 . 02 ) . Ten ( 4 percent …

The C reactive protein to prealbumin ratio correlates with the severity of multiple organ dysfunction. (1998 Nov)
The C reactive protein to prealbumin ratio correlates with the severity of multiple organ dysfunction . background : This study evaluates the correlation between a ratio of two hepatic proteins , C reactive protein ( CRP ) and prealbumin ( PALB ) , and the severity of organ dysfunction as measured by the multiple organ dysfunction score ( MODS ) . methods : A prospective cohort study was undertaken in critically ill patients ( n 70 ) by measuring the serum levels of CRP and PALB , the energy expenditure via indirect calorimetry , and severity of organ dysfunction by the MODS . All three variables were recorded for a period of 5 days from admission and then assessed for correlation to each other and to the length of stay and mortality in the intensive care unit . results : The CRP / PALB ratio showed a statistically significant correlation at 48 hours ( r 0 . 45 , P . 01 ) and 120 hours ( r 0 . 53 , P . 01 ) . This ratio showed higher degrees of correlation when applied to patients with a diagnosis of sepsis , multiple organ dysfunction , or single organ dysfunction , r 0 . 71 and 0 . 56 at 48 and 120 hours , respectively . receiver operating characteristics ( ROC ) curves show that a ratio of 2 . 07 correlated with a MODS of 16 with a sensitivity of 92 and a specificity of 71 …

Management of severe acute pancreatitis. (1994 Sep)
management of severe acute pancreatitis . currently , there is no specific therapy for acute pancreatitis . The management of the disease is supportive in approximately 80 of patients who suffer mild to moderate attacks . The remaining 20 of patients develop one or more major complications and require intensive care . classification of acute pancreatitis according to severity is , therefore , necessary for proper management . severe acute pancreatitis is detected early by the determination of circulating levels of polymorphonuclear elastase ( PMN E ) and / or C reactive protein ( CRP ) . patients with low levels of both PMN E and CRP who have no major local or systemic complication of the disease can be classified as having mild acute pancreatitis . these patients require only supportive therapy and basic monitoring of vital functions . patients with high levels of PMN E and / or CRP and disease related complications should be classified as severe . these patients should be managed in an intensive care unit for close monitoring of cardiovascular , respiratory , renal , metabolic , and hematological functions , and for early treatment of complications . Any organic dysfunction needs to be specifically treated . development of extrapancreatic organ failure is closely related to the extent of pancreatic necrosis . therefore , contrast enhanced computed tomography ( CT ) should be performed in every patient classified as having severe acute pancreatitis . If sepsis develops , fine needle ultrasound or CT guided …

C reactive protein as an indicator of sepsis. (1999 Jan)
C reactive protein as an indicator of sepsis . objective : To determine the use of plasma C reactive protein ( CRP ) concentrations , body temperature ( BT ) and white blood cell count ( WBC ) in the detection of sepsis in critically ill patients . design : All patients admitted for more than 24 h in the intensive care unit ( ICU ) were prospectively included . patients were followed up to ICU discharge and each patient day was classified in one of four categories according to the infectious status : 1 ) negative , patient day without systemic inflammatory response syndrome ( SIRS ) ; 2 ) definite , patient day with SIRS and a positive culture ; 3 ) SIRS , patient day with SIRS and negative or no cultures . The last group was subdivided according to the following criteria : a ) new , or persistence of , pulmonary infiltrates , b ) the presence of pus in a place known to be sterile . patient days without these criteria were classified as SIRS with improbable sepsis ( unlikely ) , and with one criteria or more as SIRS with probable sepsis ( probable ) . setting : medical / surgical intensive care unit . patients : twenty three patients were followed . measurements AND results : A total of 306 patient days were analysed : 20 negative , 15 definite , 63 unlikely and 208 probable . The median ( range ) …

Streptococcus pneumoniae evades complement attack and opsonophagocytosis by expressing the pspC locus encoded Hic protein that binds to short consensus … (2002 Feb)
streptococcus pneumoniae evades complement attack and opsonophagocytosis by expressing the pspC locus encoded Hic protein that binds to short consensus repeats 8 11 of factor H . streptococcus pneumoniae is an important cause of upper and lower respiratory tract infections , meningitis , peritonitis , bacterial arthritis , and sepsis . Here we have studied a novel immune evasion mechanism of serotype 3 pneumococci , which are particularly resistant to phagocytosis . On their surfaces the bacteria express the factor H binding inhibitor of complement ( Hic ) , a protein of the pneumococcal surface protein C family . using radioligand binding , microtiter plate assays , surface plasmon resonance analysis , and recombinant constructs of factor H , we located the binding site of Hic to short consensus repeats ( SCRs ) 8 11 in the middle part of factor H . This represents a novel microbial interaction region on factor H . The only other ligand known so far for SCRs 8 11 of factor H is C reactive protein ( CRP ) , an acute phase protein that binds to the pneumococcal C polysaccharide . The binding sites of Hic and CRP within the SCR8 11 region were different , however , because CRP did not inhibit the binding of Hic and required calcium for binding . binding of factor H to Hic expressing pneumococci promoted factor I mediated cleavage of C3b and restricted phagocytosis of pneumococci . Thus , virulent pneumococci avoid complement attack and opsonophagocytosis …

The protective effect of acute phase reactants in neonatal sepsis. (1979 Sep)
The protective effect of acute phase reactants in neonatal sepsis . phase reactants were evaluated prospectively in babies suspected of having sepsis . among 318 babies , there were 22 proven and 10 very probable cases of neonatal sepsis . Of the proven cases 14 survived and 8 died . The survivors had a positive latex C reactive protein ( CRP ) in 11 cases and an alpha1 acid glycoprotein ( AGP ) level greater than 0 . 5 g / l in 12 cases . among those who died , one had a positive latex CRP and none had AGP greater than 0 . 5 g / l . these findings were supported by positive CRP and elevated AGP in almost all very probable cases , all of whom survived . these data in newborn infants support the hypothesis that acute phase reactants have a functional role in combating infection .

Inhibition of post traumatic septic proteolysis and ureagenesis and stimulation of hepatic acute phase protein production by branched chain amino … (1988 Sep)
inhibition of post traumatic septic proteolysis and ureagenesis and stimulation of hepatic acute phase protein production by branched chain amino acid TPN . previous studies have shown that severe sepsis after major trauma results in the reprioritization of release of hepatic acute phase proteins ( APP ) . They suggest competition for leucine for nutritional utilization may be responsible . To test this hypothesis , a branched chain enriched ( 46 . 6 ) amino acid mixture ( BCAA ) was administered on a prospective randomized basis with standard TPN therapy to 16 septic post trauma patients . after sepsis was diagnosed , a randomized therapy ( control TPN or BCAA TPN ) was given for 12 days , or until death occurred . total calories and amino acid nitrogen ( N ) administered were not different in the two groups ( t test ) and q 8 h ( 347 study periods ) amino acid clearances , urinary urea nitrogen excretion , muscle proteolysis from 3 methyl histidine ( 3 MH ) excretion , and standard indices of sepsis severity and hepatic function were measured , as well as platelets ( PLAT ) , leucocytes ( WBC ) , albumin ( ALB ) , and six acute phase proteins : C reactive protein ( CRP ) , alpha 1 antitrypsin ( a1trip ) , fibrinogen ( fibrin ) , alpha 2 macroglobulin ( amacro ) , ceruloplasmin ( cerul ) , and transferrin ( trans ) . using scheffé …

Intensive insulin therapy exerts antiinflammatory effects in critically ill patients and counteracts the adverse effect of low mannose binding lectin … (2003 Mar)
intensive insulin therapy exerts antiinflammatory effects in critically ill patients and counteracts the adverse effect of low mannose binding lectin levels . adverse outcome of critical illness is often caused by systemic inflammation and sepsis . A recent study showed that mortality is significantly reduced by maintenance of normoglycemia using intensive insulin therapy . We examined whether the beneficial effects of intensive insulin therapy involve modulations of mannose binding lectin ( MBL ) and C reactive protein ( CRP ) levels . From a study of 1548 patients randomly assigned to either conventional treatment or intensive insulin therapy at an intensive care unit ( ICU ) we included all 451 patients who needed prolonged intensive care ( 5 d ) . CRP and MBL concentrations were measured on admission , d 5 , d 15 , and the last day in the ICU . In all patients , serum MBL concentrations increased with time in the ICU ( P 0 . 0001 ) . This acute phase response was suppressed by intensive insulin therapy at all time points studied ( P 0 . 02 ) . selectively in patients receiving conventional therapy , MBL concentrations at baseline were almost 3 times higher in survivors than in nonsurvivors ( P 0 . 04 ) . baseline CRP concentrations were elevated , but decreased with time in ICU ( P 0 . 0001 ) . The decrease in CRP was significantly more pronounced in the intensive insulin treated patients compared with the …

Procalcitonin and C reactive protein as markers of systemic inflammatory response syndrome severity in critically ill children. (2007 Feb)
procalcitonin and C reactive protein as markers of systemic inflammatory response syndrome severity in critically ill children . objectives : To analyse the clinical value of procalcitonin ( PCT ) , C reactive protein ( CRP ) and leucocyte count in the diagnosis of paediatric sepsis and in the stratification of patients according to severity . design : prospective , observational study . setting : paediatric intensive care unit ( PICU ) . patients : ninety four children . measurement AND results : leucocyte count , PCT and CRP were measured when considered necessary during the PICU stay . patients were classified , when PCT and CRP were measured , into one of six categories ( negative , SIRS , localized infection , sepsis , severe sepsis , and septic shock ) according to the definitions of the american college of chest physicians / society of critical Care medicine . A total of 359 patient day episodes were obtained . leucocyte count did not differ across the six diagnostic classes considered . median plasma PCT concentrations were 0 . 17 , 0 . 43 , 0 . 79 , 1 . 80 , 15 . 40 and 19 . 13 ng / ml in negative , systemic inflammatory response syndrome ( SIRS ) , localized infection , sepsis , severe sepsis , and septic shock groups , respectively , whereas median plasma CRP concentrations were 1 . 35 , 3 . 80 , 6 . 45 , 5 . 70 …

Interleukin 6 , procalcitonin , C reactive protein and the immature to total neutrophil ratio ( I / T ) … (2001 Jun)
interleukin 6 , procalcitonin , C reactive protein and the immature to total neutrophil ratio ( I / T ) in the diagnosis of early onset sepsis in low birth weight neonates objective : To determine the influence of early onset neonatal sepsis on interleukin 6 ( IL 6 ) and procalcitonin ( PCT ) levels in cord blood . To evaluate the significance of usually used infection markers C reactive protein ( CRP ) and immature to total neutrophil ratio ( I / T ) and new markers ( PCT , IL 6 ) for the diagnosis of early onset neonatal sepsis . design : prospective clinical study . setting : institute for the Care of mother and child , prague . methods : The serum levels of IL 6 and PCT were measured in cord blood in 37 low birht weight infants less than 35 week of gestation born in our institute . IL 6 and PCT levels were further evaluated together with CRP and I / T in neonatal blood within 2 hours after delivery . neonatal sepsis within the first 72 hours of life was monitored . results : differences in mean values of CRP , I / T , IL 6 , and PCT between sepsis proven and sepsis not proven groups were not statistically significant . Only the difference between groups in cord blood PCT was of borderline significance ( p 0 . 06 , higher in sepsis proven group ) . fisher test …

Procalcitonin , lipopolysaccharide binding protein , interleukin 6 and C reactive protein in community acquired infections and sepsis : a … (2006 Aug)
procalcitonin , lipopolysaccharide binding protein , interleukin 6 and C reactive protein in community acquired infections and sepsis : a prospective study . introduction : clinicians are in need of better diagnostic markers in diagnosing infections and sepsis . We studied the ability of procalcitonin , lipopolysaccharide binding protein , IL 6 and C reactive protein to identify patients with infection and sepsis . methods : plasma and serum samples were obtained on admission from patients with suspected community acquired infections and sepsis . procalcitonin was measured with a time resolved amplified cryptate emission technology assay . lipopolysaccharide binding protein and IL 6 were measured with a chemiluminescent immunometric assay . results : Of 194 included patients , 106 had either infection without systemic inflammatory response syndrome or sepsis . infected patients had significantly elevated levels of procalcitonin , lipopolysaccharide binding protein , C reactive protein and IL 6 compared with noninfected patients ( P 0 . 001 ) . In a receiver operating characteristic curve analysis , C reactive protein and IL 6 performed best in distinguishing between noninfected and infected patients , with an area under the curve larger than 0 . 82 ( P 0 . 05 ) . IL 6 , lipopolysaccharide binding protein and C reactive protein performed best in distinguishing between systemic inflammatory response syndrome and sepsis , with an area under the curve larger than 0 . 84 ( P 0 . 01 ) . procalcitonin performed best in distinguishing between sepsis and …