title: CRP/CD11b ratio: a novel parameter for detecting gram-positive sepsis.
abstract: To commence proper antibiotic treatment in sepsis, timely knowledge of whether the cause of systemic infection is gram-negative (gram(-)) or gram-positive (gram(+)) bacteria in origin would be beneficial for clinicians. In this clinical prospective study, our objective was to develop a method for distinguishing between gram(+) and gram(-) bacterial infection. In gram(-) bacterial infection (n = 21), the average amount of CD11b on neutrophils was significantly higher than in gram(+) bacterial infection (n = 22). On the contrary, serum C-reactive protein (CRP) level was significantly higher in gram(+) than in gram(-) bacterial infection. By dividing the serum CRP value by the amount of CD11b on neutrophils, we derived a novel marker of gram(+) sepsis, CRP/CD11b ratio, which displayed 76% sensitivity and 80% specificity for the detection of gram(+) sepsis (n = 17) among febrile patients with microbiologically confirmed or clinically diagnosed bacterial infection. The detection of gram(+) sepsis is possible after the combination of neutrophil CD11b data and serum CRP level. In conclusion, our findings indicate that the proposed CRP/CD11b ratio test could potentially assist physicians in determining an appropriate antibiotic treatment in patients with severe bacterial infection.
authors.affiliation: Department of Biochemistry, University of Turku, Vatselankatu 2, 20014 Turku, Finland. jarnuu@utu.fi
authors.forename: Jari
authors.initials: J
authors.lastname: Nuutila
authors.forename: Päivi
authors.initials: P
authors.lastname: Jalava-Karvinen
authors.forename: Ulla
authors.initials: U
authors.lastname: Hohenthal
authors.forename: Iina
authors.initials: I
authors.lastname: Laitinen
authors.forename: Pirkko
authors.initials: P
authors.lastname: Kotilainen
authors.forename: Allan
authors.initials: A
authors.lastname: Rajamäki
authors.forename: Jukka
authors.initials: J
authors.lastname: Nikoskelainen
authors.forename: Esa-Matti
authors.initials: EM
authors.lastname: Lilius
mesh_terms: D000704:Analysis of Variance; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis*; D039481:CD11b Antigen / Q000097:blood*; D003937:Diagnosis, Differential; D005434:Flow Cytometry; D016905:Gram-Negative Bacterial Infections / Q000097:blood / Q000175:diagnosis; D016908:Gram-Positive Bacterial Infections / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D009504:Neutrophils / Q000378:metabolism; D017463:Receptors, Complement 3b / Q000097:blood; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood / Q000175:diagnosis*
chemical_list: D039481:CD11b Antigen; D017463:Receptors, Complement 3b; D002097:C-Reactive Protein