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Characterizing CRP dynamics during acute infections.

Stacey S Cherny1,2, Rafael Y Brzezinski3,4, Asaf Wasserman3,4

  • 1Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medical & Health Sciences Tel Aviv University, Tel Aviv, Israel.

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This summary is machine-generated.

C-reactive protein (CRP) levels vary significantly with infection type and antibiotic use. Tracking CRP dynamics offers valuable insights for diagnosing and managing hospitalized patients with infections.

Keywords:
AntibioticsBacteremiaCRP dynamicsCRP trajectoriesInfection

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Area of Science:

  • Clinical Medicine
  • Infectious Diseases
  • Biomarkers

Background:

  • C-reactive protein (CRP) is a widely used marker for inflammation.
  • Detailed understanding of CRP dynamics during acute infections is limited.
  • Characterizing CRP trajectories can aid in infection management.

Purpose of the Study:

  • To analyze C-reactive protein (CRP) trajectories in hospitalized patients.
  • To differentiate CRP patterns in viral infections, bacteremia (Gram-negative and Gram-positive), and non-bacteremic conditions.
  • To assess the influence of antibiotic treatment on CRP levels.

Main Methods:

  • Retrospective analysis of electronic medical records (July 2007-May 2023).
  • Inclusion of patients with positive blood cultures or viral tests.
  • Modeling CRP levels using generalized additive mixed-effects models (GAMMs) up to 150 hours post-diagnosis, excluding patients with initial CRP > 31.9 mg/L.

Main Results:

  • Viral infections exhibited the lowest and flattest CRP curves.
  • Non-bacteremic infections showed intermediate CRP levels.
  • Bacteremia, particularly Gram-negative infections under antibiotic treatment, displayed the highest peak CRP levels, ranging from 15.4 mg/L (viral, no antibiotics) to 140.9 mg/L (Gram-negative bacteremia, with antibiotics).

Conclusions:

  • C-reactive protein (CRP) trajectories are distinct for different infection types and are influenced by antibiotic interventions.
  • Serial CRP measurements can serve as a crucial tool for diagnosis and risk stratification in hospitalized patients.