Limits...
Is the concentration of C-reactive protein in bacteraemia associated with age?

Wester AL, Blaasaas KG, Wyller TB - Immun Ageing (2008)

Bottom Line: The median CRP1 and CRP2 were significantly higher in the youngest age group.The area under the ROC-curve for the youngest age group was significantly greater than that of the two other age groups, but we found no statistically significant differences in sensitivity related to age.We found a weakening of the CRP-response with age, but this is hardly of clinical significance.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Bacteriology, Aker University Hospital, N-0514, Oslo, Norway. asts@uus.no

ABSTRACT

Background: C-reactive protein (CRP) is an indicator of inflammation, and is often used in the diagnosis of bacterial infections. It is poorly known whether CRP in bacterial infection is age-dependent.

Methods: Adult patients with a positive blood culture with E. coli or S. pneumoniae during 1994-2004 were included. CRP measured on the same date as the blood cultures were drawn (CRP1), 2-3 days (CRP2) and 4-7 days later (CRP3), were retrieved. The patients were divided into three age groups, < 65, 65-84, and > or = 85, respectively. We studied three cut-off values for CRP and produced age-specific receiver operating characteristics (ROC) curves, using patients with acute coronary or cerebral infarction as controls.

Results: 890 patients and 421 controls were available. There was a statistically significant negative correlation between age and CRP1 - 0.072 (p = 0.032). The median CRP1 and CRP2 were significantly higher in the youngest age group. The area under the ROC-curve for the youngest age group was significantly greater than that of the two other age groups, but we found no statistically significant differences in sensitivity related to age. The diagnostic sensitivity of CRP was better for S. pneumoniae than for E. coli, 92.6% vs. 88.0% (p = 0.046) for a cut-off value of 40 mg/L, and 82.4% vs. 61.5% (p =< 0.01) for a cut-off value of 120 mg/L.

Conclusion: CRP is better in identifying infection with S. pneumoniae than with E. coli. We found a weakening of the CRP-response with age, but this is hardly of clinical significance.

No MeSH data available.


Related in: MedlinePlus

Scatter plot of the relation between age and CRP concentration on the day of a blood culture positive for S. pneumoniae or E. coli (cases), and for the controls.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2542342&req=5

Figure 1: Scatter plot of the relation between age and CRP concentration on the day of a blood culture positive for S. pneumoniae or E. coli (cases), and for the controls.

Mentions: The median concentration of CRP on the same day as the positive blood culture (CRP1) was 188 mg/L (IQR 97–288 mg/L). For the control group taken together the median CRP concentration at admittance was 6 mg/L (IQR 2–19 mg/L, range 1–303 mg/L), 5 mg/L (IQR 2–12 mg/L) for those with cerebral infarction and 7 mg/L (IQR 2–24 mg/L) for those with myocardial infarction. The relation between CRP1 and age with trendlines is shown in figure 1. The Spearman correlation coefficient was – 0.072 (p = 0.032) and 0.146 (p = 0.003) among the cases and the controls, respectively. For bacteraemic patients the median CRP1 was 209.5 (IQR 110–320), 175 (IQR 83–271) and 176 mg/L (IQR 103–278), in the youngest, median and oldest age group, respectively. Corresponding results among the controls were 4 (IQR 2 – 11), 6 (IQR 2 – 20) and 11 mg/L (IQR 3 – 43).


Is the concentration of C-reactive protein in bacteraemia associated with age?

Wester AL, Blaasaas KG, Wyller TB - Immun Ageing (2008)

Scatter plot of the relation between age and CRP concentration on the day of a blood culture positive for S. pneumoniae or E. coli (cases), and for the controls.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2542342&req=5

Figure 1: Scatter plot of the relation between age and CRP concentration on the day of a blood culture positive for S. pneumoniae or E. coli (cases), and for the controls.
Mentions: The median concentration of CRP on the same day as the positive blood culture (CRP1) was 188 mg/L (IQR 97–288 mg/L). For the control group taken together the median CRP concentration at admittance was 6 mg/L (IQR 2–19 mg/L, range 1–303 mg/L), 5 mg/L (IQR 2–12 mg/L) for those with cerebral infarction and 7 mg/L (IQR 2–24 mg/L) for those with myocardial infarction. The relation between CRP1 and age with trendlines is shown in figure 1. The Spearman correlation coefficient was – 0.072 (p = 0.032) and 0.146 (p = 0.003) among the cases and the controls, respectively. For bacteraemic patients the median CRP1 was 209.5 (IQR 110–320), 175 (IQR 83–271) and 176 mg/L (IQR 103–278), in the youngest, median and oldest age group, respectively. Corresponding results among the controls were 4 (IQR 2 – 11), 6 (IQR 2 – 20) and 11 mg/L (IQR 3 – 43).

Bottom Line: The median CRP1 and CRP2 were significantly higher in the youngest age group.The area under the ROC-curve for the youngest age group was significantly greater than that of the two other age groups, but we found no statistically significant differences in sensitivity related to age.We found a weakening of the CRP-response with age, but this is hardly of clinical significance.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Bacteriology, Aker University Hospital, N-0514, Oslo, Norway. asts@uus.no

ABSTRACT

Background: C-reactive protein (CRP) is an indicator of inflammation, and is often used in the diagnosis of bacterial infections. It is poorly known whether CRP in bacterial infection is age-dependent.

Methods: Adult patients with a positive blood culture with E. coli or S. pneumoniae during 1994-2004 were included. CRP measured on the same date as the blood cultures were drawn (CRP1), 2-3 days (CRP2) and 4-7 days later (CRP3), were retrieved. The patients were divided into three age groups, < 65, 65-84, and > or = 85, respectively. We studied three cut-off values for CRP and produced age-specific receiver operating characteristics (ROC) curves, using patients with acute coronary or cerebral infarction as controls.

Results: 890 patients and 421 controls were available. There was a statistically significant negative correlation between age and CRP1 - 0.072 (p = 0.032). The median CRP1 and CRP2 were significantly higher in the youngest age group. The area under the ROC-curve for the youngest age group was significantly greater than that of the two other age groups, but we found no statistically significant differences in sensitivity related to age. The diagnostic sensitivity of CRP was better for S. pneumoniae than for E. coli, 92.6% vs. 88.0% (p = 0.046) for a cut-off value of 40 mg/L, and 82.4% vs. 61.5% (p =< 0.01) for a cut-off value of 120 mg/L.

Conclusion: CRP is better in identifying infection with S. pneumoniae than with E. coli. We found a weakening of the CRP-response with age, but this is hardly of clinical significance.

No MeSH data available.


Related in: MedlinePlus