Using the kinetics of C-reactive protein response to improve the differential diagnosis between acute bacterial and viral infections.
Purpose: Differential diagnosis between acute viral and bacterial infection is an emerging common challenge for a physician in the emergency department. Serum C-reactive protein (CRP) is used to support diagnosis of bacterial infection, but in patients admitted with low CRP, its ability to discrimin...
| Publicado en: | Infection Vol. 48; no. 2; pp. 241 - 249 |
|---|---|
| Autores principales: | , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Apr2020
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=142436077&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 142436077 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Apr2020 vid: 48 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 142436077 142436077 142436077 10.1007/s15010-019-01383-6 142436077 ppf: 241 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Using the kinetics of C-reactive protein response to improve the differential diagnosis between acute bacterial and viral infections. aug: au: Coster, Dan Wasserman, Asaf Fisher, Eyal Rogowski, Ori Zeltser, David Shapira, Itzhak Bernstein, Daniel Meilik, Ahuva Raykhshtat, Eli Halpern, Pinchas Berliner, Shlomo Shenhar-Tsarfaty, Shani Shamir, Ron affil: Blavatnik School of Computer Science, Tel-Aviv University, Tel Aviv, Israel sug: subj: Virus Diseases Diagnosis Bacterial Infections Diagnosis C-Reactive Protein Blood Diagnosis, Differential Kinetics Human Retrospective Design Record Review Adult Inpatients Sensitivity and Specificity Descriptive Statistics Microbiological Techniques Adult: 19-44 years ab: Purpose: Differential diagnosis between acute viral and bacterial infection is an emerging common challenge for a physician in the emergency department. Serum C-reactive protein (CRP) is used to support diagnosis of bacterial infection, but in patients admitted with low CRP, its ability to discriminate between viral and bacterial infections is limited. We aimed to use two consecutive CRP measurements in order to improve differential diagnosis between bacterial and viral infection. Methods: A single-center retrospective cohort (n = 1629) study of adult patients admitted to the emergency department with a subsequent microbiological confirmation of either viral or bacterial infection. Trend of CRP was defined as the absolute difference between the first two measurements of CRP divided by the time between them, and we investigated the ability of this parameter to differentiate between viral and bacterial infection. Results: In patients with relatively low initial CRP concentration (< 60 mg/L, n = 634 patients), where the uncertainty regarding the type of infection is the highest, the trend improved diagnosis accuracy (AUC 0.83 compared to 0.57 for the first CRP measurement). Trend values above 3.47 mg/L/h discriminated bacterial from viral infection with 93.8% specificity and 50% sensitivity. Conclusions: The proposed approach for using the kinetics of CRP in patients whose first CRP measurement is low can assist in differential diagnosis between acute bacterial and viral infection. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|