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Published on: February 24, 2023
C-Reactive Protein for Early Diagnosis and Severity Monitoring in Melioidosis: A Systematic Review and Meta-Analysis
Atthaphong Phongphithakchai1, Moragot Chatatikun2,3, Jitabanjong Tangpong2,3
1Nephrology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
Abstract:
Background: Melioidosis, caused by Burkholderia pseudomallei, is a serious infectious disease in Southeast Asia and northern Australia. Methods: We systematically reviewed observational studies measuring C-reactive protein (CRP) in laboratory-confirmed melioidosis for diagnosis, severity assessment, or outcome evaluation. PubMed, Embase, and Scopus were searched up to May 2025. Data were pooled using a random-effects model; heterogeneity was quantified (I2). Results: Seven studies (n = 451) were included. The pooled mean CRP level in melioidosis was 74.37 mg/L (95% Confidence Interval [CI], 32.76-168.83; I2 = 99.1%), considerably higher than healthy reference values (<10 mg/L). Conclusions: CRP is consistently raised in melioidosis and may aid in early diagnosis and severity monitoring, although high heterogeneity limits the precision of pooled estimates. Integration of CRP into multimodal prediction tools, rather than use in isolation, is recommended. Further prospective studies should define optimal diagnostic thresholds.
Insights
C-reactive protein (CRP) is significantly elevated in melioidosis, a serious bacterial infection. This finding suggests CRP may help diagnose the disease and monitor its severity.
Area of Science:
- Infectious Diseases
- Clinical Chemistry
- Epidemiology
Background:
- Melioidosis is a severe infectious disease caused by Burkholderia pseudomallei.
- It is endemic in Southeast Asia and northern Australia.
- Accurate diagnosis and severity assessment are crucial for patient outcomes.
Purpose of the Study:
- To systematically review observational studies on C-reactive protein (CRP) in melioidosis.
- To evaluate the utility of CRP in diagnosis, severity assessment, and outcome prediction.
- To synthesize existing evidence on CRP levels in laboratory-confirmed melioidosis.
Main Methods:
- Systematic literature search of PubMed, Embase, and Scopus up to May 2025.
- Inclusion of seven observational studies with 451 participants.
- Meta-analysis using a random-effects model to pool CRP levels.
Main Results:
- The pooled mean C-reactive protein (CRP) level in melioidosis patients was 74.37 mg/L.
- This level is substantially higher than healthy reference values (<10 mg/L).
- High heterogeneity (I² = 99.1%) was observed in the pooled estimates.
Conclusions:
- C-reactive protein (CRP) is consistently elevated in melioidosis patients.
- CRP may assist in early diagnosis and monitoring disease severity.
- Further research is needed to establish optimal diagnostic thresholds and integrate CRP into predictive models.
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