C-reactive protein as predictor of bacterial infection among patients with an influenza-like illness
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UMass Chan Affiliations
Department of Medicine, Division of Infectious Diseases and ImmunologyDepartment of Emergency Medicine
Document Type
Journal ArticlePublication Date
2013-01-01Keywords
AdolescentAdult
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
Metadata
Show full item recordAbstract
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 siteDOI
10.1016/j.ajem.2012.06.026Permanent Link to this Item
http://hdl.handle.net/20.500.14038/29895PubMed ID
22944552Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.ajem.2012.06.026