C-reactive protein concentrations during bacteraemia: A comparison between patients with and without liver dysfunction.
OBJECTIVE
To evaluate the value of serum C-reactive protein (CRP) concentrations as a marker of sepsis in patients with biochemical evidence of liver dysfunction.


METHODS
A retrospective case-control comparison of serum CRP concentrations between patients with and those without liver dysfunction (prothrombin time over 18 s and serum bilirubin > or = 20 micromol/l) during their first episode of bacteraemia.


METHODS
The neurosciences and general adult intensive care units of a university teaching hospital.


METHODS
Any patient from the above settings with a first episode of bacteraemia (first isolate of pathogenic bacteria from blood cultures) over a 3-year period.


RESULTS
After exclusions 126 first episodes of bacteraemia were identified, of which 33 were in patients with liver dysfunction. Serum CRP concentrations were significantly lower in patients with liver dysfunction (median 103 mg/l, IQR 29-204) than in those without (146 mg/l, 74, > 250).


CONCLUSIONS
Patients with biochemical evidence of liver disease generate significantly lower serum CRP concentrations during bacteraemia than patients without liver dysfunction. Serum CRP concentrations should be interpreted with caution in patients with liver disease to diagnose and monitor bacterial sepsis.
Mackenzie
Iain
I
John Farman Intensive Care Unit, Box 17, Addenbrooke's Hospital, CB2 2QQ, Cambridge, UK. iain@number2.demon.co.uk
Woodhouse
Joe
J
D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000378:metabolism* / Q000382:microbiology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
D015415:Biomarkers; D002097:C-Reactive Protein