24 April 2006

C-reactive protein levels good predictor of infection in critically ill patients

Daily monitoring of C-reactive protein levels could help in the prediction of infections acquired in the intensive care unit. A study published today in the journal Critical Care reveals that a daily variation of C-reactive protein (CRP) levels greater than 4.1 mg/dl is a good marker for prediction of infection. The authors of the study also identify different patterns of CRP level progression, associated with different predictions of infection, which could guide antibiotic prescription.

Pedro Povoa, from Hospital de São Francisco Xavier in Lisbon, Protugal and colleagues from the Hospital Garcia de Orta in Almada, Portugal analysed the CRP levels of patients admitted to their intensive care unit (ICU) during 72 hours or more. Among the patients selected for the study, 35 acquired an infection during their stay at the ICU and 28 did not. Povoa et al. analysed the patients' records of CRP levels during the five days before diagnosis of infection or ICU discharge, respectively.

Povoa et al. found that a daily variation of CRP levels greater than 4.1 mg/dl is a good marker for prediction of infection, with 92.1% sensitivity and 71.4% specificity. If combined with a CRP concentration greater than 8.7 mg/dl, the prediction power increased even further. Eighty-eight percent of patients with a daily variation of CRP levels greater than 4.1 mg/dl and a CRP concentration greater than 8.7 mg/dl developed an infection. Povoa et al.conclude that monitoring CRP progression could help in clinical decision-making and the prescription of antibiotics.

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Article:
Early identification of ICU-acquired infections with daily monitoring of C-reactive protein: a prospective observational study
Pedro R Povoa, Luis M Coelho, Eduardo P Almeida, Antero V Fernandes, Rui J Mealha, Pedro M Moreira and Henrique J Sabino
Critical Care 2006, 10: R63 (24 April 2006)

Journal website:
http://ccforum.com/
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For more information about this study, or about the journal, contact Juliette Savin by email at press@biomedcentral.com or by phone on +44 (0)20 7631 9931

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