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    C-reactive protein as predictor of bacterial infection among patients with an influenza-like illness

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    Authors
    Haran, John Patrick
    Beaudoin, Francesca Lynn
    Suner, Selim
    Lu, Shan
    UMass Chan Affiliations
    Department of Medicine, Division of Infectious Diseases and Immunology
    Department of Emergency Medicine
    Document Type
    Journal Article
    Publication Date
    2013-01-01
    Keywords
    Adolescent
    Adult
    Aged
    Analysis of Variance
    Bacterial Infections
    Biological Markers
    C-Reactive Protein
    Female
    Humans
    Influenza, Human
    Male
    Middle Aged
    Predictive Value of Tests
    Prospective Studies
    ROC Curve
    Sensitivity and Specificity
    Trauma Centers
    Virus Diseases
    Bacterial Infections and Mycoses
    Diagnosis
    Emergency Medicine
    Immunology and Infectious Disease
    Infectious Disease
    Influenza Humans
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    Link to Full Text
    http://dx.doi.org/10.1016/j.ajem.2012.06.026
    Abstract
    OBJECTIVE: During the influenza season patients are labeled as having an influenza-like illness (ILI) which may be either a viral or bacterial infection. We hypothesize that C-reactive protein (CRP) levels among patients with ILI diagnosed with a bacterial infection will be higher than patients diagnosed with an influenza or another viral infection. METHODS: We enrolled a convenience sample of adults with ILI presenting to an urban academic emergency department from October to March during the 2008 to 2011 influenza seasons. Subjects had nasal aspirates for viral testing, and serum CRP. Bacterial infection was determined by positive blood cultures, radiographic evidence of pneumonia, or a discharge diagnosis of bacterial infection. Receiver operating characteristic curve, analysis of variance, and Student t test were used to analyze results. RESULTS: Over 3 influenza seasons there were 131 total patients analyzed (48 influenza infection, 42 other viral infection and 41 bacterial infection). CRP values were 25.65 mg/L (95% CI, 18.88-32.41) for influenza, 18.73 mg/L (95% CI, 12.97-24.49) for viral and 135.96 mg/L (95% CI, 99.38-172.54) for bacterial. There was a significant difference between the bacterial group, and both the influenza and other viral infection groups (P < .001). The receiver operating characteristic curve for CRP as a determinant of bacterial infection had an area under the curve of 0.978, whereby a CRP value of 80 had a specificity of 100%. CONCLUSION: C-reactive protein is both a sensitive and specific marker for bacterial infection in patients presenting with ILI during the influenza season.
    Source
    Am J Emerg Med. 2013 Jan;31(1):137-44. doi: 10.1016/j.ajem.2012.06.026. Link to article on publisher's site
    DOI
    10.1016/j.ajem.2012.06.026
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29895
    PubMed ID
    22944552
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ajem.2012.06.026
    Scopus Count
    Collections
    UMass Chan Faculty and Researcher Publications
    Emergency Medicine Publications

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