title: Modeling C-reactive protein kinetic profiles for use as a clinical prediction tool in patients with Staphylococcus aureus bacteremia.
abstract: OBJECTIVE
  We hypothesized that C-reactive protein (CRP) kinetics can be accurately modeled and might have clinical utility in a cohort of patients with Staphylococcus aureus bacteremia.
  
  
  METHODS
  We constructed and validated a nonlinear mixed effects model using CRP values obtained during the first week of illness.
  
  
  RESULTS
  Hematological malignancy, prosthetic heart valves and metastatic seeding were identified as major covariates that influenced CRP kinetics. When considering the presence of metastatic infection as an 'unknown', the model could predict its presence through analysis of the observed CRP profile with an Area-under-the-Receiver-Operator-Characteristic curve of 0.81, indicating some diagnostic accuracy.
  
  
  CONCLUSIONS
  We conclude that early CRP kinetics can be accurately modeled and can help identify patients with metastatic seeding in S. aureus bacteremia. Further validation is required.
authors.affiliation: Pathwest Laboratory Medicine, Nedlands, WA, Australia.|Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gliddon
authors.affiliation: Sir Charles Gairdner Hospital, Nedlands, WA, Australia.|Harry Perkins Research Institute, School of Medicine & Pharmacology, University of Western Australia, Fiona Stanley Hospital, Western Australia, University of Western Australia, WA, Australia.
authors.forename: Sam
authors.initials: S
authors.lastname: Salman
authors.affiliation: Pathwest Laboratory Medicine, Nedlands, WA, Australia.|Australian Collaborating Centre for Enterococcus & Staphylococcus Species (ACCESS) Typing & Research, School of Veterinary & Life Sciences, Murdoch University & School of Biomedical Sciences, Curtin University, Perth, WA, Australia.|Royal Perth Hospital, Perth, WA, Australia.|Fiona Stanley Hospital, Murdoch, WA, Australia.
authors.forename: James Owen
authors.initials: JO
authors.lastname: Robinson
authors.affiliation: Harry Perkins Research Institute, School of Medicine & Pharmacology, University of Western Australia, Fiona Stanley Hospital, Western Australia, University of Western Australia, WA, Australia.
authors.forename: Laurens
authors.initials: L
authors.lastname: Manning
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000097:blood*; D013211:Staphylococcus aureus / Q000502:physiology*
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein; Staphylococcus aureus bacteremia; biomarkers; nonlinear mixed effects modeling