C-reactive protein is a useful predictor of metronidazole treatment failure in mild-to-moderate Clostridium difficile infection

Farne, Hugo; Martin, Natasha K.; Main, Janice; Orchard, Timothy R.; Tyrrell-Price, Jonathan

doi:10.1097/meg.0b013e328359ed6c

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…Correspondingly, a change in CRP levels may be used to determine when antibiotics can be discontinued. [30][31][32] However, a prospective study is needed to confirm these recommendations.…”

Section: Discussionmentioning

confidence: 99%

Measuring both procalcitonin and C-reactive protein for a diagnosis of sepsis in critically ill patients

et al. 2014

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Background: The usefulness of procalcitonin (PCT) and C-reactive protein (CRP) as individual biomarkers, and in combination, for the identification of infections in a critically ill patient cohort was evaluated retrospectively. Methods: Best cut-off values for PCT and CRP for a diagnosis of sepsis in critically ill patients were determined using receiver operator characteristic (ROC) curve analysis. Both combined tests and individual tests were performed for PCT and CRP, with positive and negative results recorded, and accuracy evaluated using odds ratios (OR). Results: In the 55 critically ill patients studied, the best cut-off value for PCT for a diagnosis of sepsis was 1.1 ng/ml (sensitivity, specificity and negative predictive values [NPV] were 82%, 68% and 71%, respectively). In addition, the best cut-off value for CRP was 50.7 mg/l ( sensitivity, specificity and NPV of 90%, 68% and 83%, respectively). Measuring PCT and CRP in combination provided a sensitivity of 79%, a specificity of 86%, and a positive predictive value (PPV) of 90%. Diagnostic OR for the combination of biomarkers versus CRP alone (19 and 18, respectively) were greater than that for PCT (9). Conclusion: For critically ill patients, CRP and CRP in combination with PCT were found to be suitable biomarkers for diagnosing sepsis, based on their NPV and PPV.

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Section: Discussionmentioning

confidence: 99%

Measuring both procalcitonin and C-reactive protein for a diagnosis of sepsis in critically ill patients

et al. 2014

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“…However, it was reported that Clostridium Difficile infection may be associated with a relapse of symptoms in patients with inflammatory bowel disease, in whom this infection can occur even in the absence of antibiotic use [5]. In our case metronidazole was given for one month, which is longer than the recommended length of treatment for an uncomplicated Clostridium Difficile infection [6,7].…”

Section: Discussionmentioning

confidence: 64%

Clostridium Difficile Infection and Biliary Obstruction

Stoian¹

2021

JCRR

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We present a case of a 38-year -old man was admitted to the hospital with biliary obstruction and Clostridium Difficile infection. He presented with moderate increases in the aminotransferase and bilirubin levels suggesting the diagnosis of an autoimmune hepatobiliary disease; intestinal protein loss needs to evaluate an associated inflammatory bowel disease. The clinical diagnosis of autoimmune hepatobiliary disease associated with inflammatory bowel disease is based on the patients symptoms and the presence of a protein-losing enteropathy which are more suggestive of Crohn disease, while moderate increases in the aminotransferase levels in proportion to the increase in the bilirubin level suggesting the diagnosis of primary sclerosing cholangitis. The pathological and positive diagnosis needs an endoscopic retrograde cholangiopancreatography and a biopsy of gastric and duodenum mucosae who showed severe inflammation findings that are diagnostic of Crohn disease.

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“…Serum CRP levels could be used as a biomarker for estimating the likelihood of recurrence and mortality in patients with C. difficile-associated diarrhea (25). Elevated CRP levels have been identified as a significant risk factor for severe CDI, and they can also be used as an indicator of inadequate response to metronidazole in patients with mild-to-moderate CDI (26). The prognostic value of serum inflammatory markers, such as CRP, can guide clinicians in diagnosing CDI caused by NAP1/027 strains earlier and control nosocomial infection and outbreak.…”

Section: Discussionmentioning

confidence: 99%

Clostridium difficile Infection Risk Factors and Outcomes Among Inpatients Infected with NAP1/BI/027 Strain Compared to Non-NAP1 Strain in a Major Chinese Hospital

Yao

Wang

Shao

et al. 2023

Jundishapur J Microbiol

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Background: NAP1/027 Clostridium difficile infection (CDI) has rarely been reported in China. Objectives: The objective of this study was to strengthen the understanding of the risk factors and outcomes of NAP1/027 CDI. Methods: A single-center, retrospective, case-control (1: 3) study was performed to identify risk factors and outcomes specific to NAP1/027 CDI using a group of patients with NAP1/027 CDI (n = 20) and a group of age-matched control patients with non-NAP1/027 CDI (n = 60) within June 2018 and August 2021. The patient charts were thoroughly reviewed to assess the markers of severity, risk factors, and outcomes. Results: Out of the 272 stool specimens, 41 cases (15.07%) tested positive for the NAP1 strain of C. difficile using the polymerase chain reaction. Among these specimens, 20 cases fulfilled the inclusion criteria. No significant difference was observed between the NAP1/027 and non-NAP1/027 groups in disease severity, length of hospital stay, or mortality. Logistic regression analysis revealed that risk factors for acquiring NAP1/027 infection included hospitalization in the 90 days before CDI diagnosis and high C-reactive protein level within ± 3 days of C. difficile detection. Conclusions: In a large non-epidemic tertiary hospital in China, NAP1/027 strains were more prevalent in patients with previous hospitalization and high CRP level than non-NAP1/027 strains.

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C-reactive protein is a useful predictor of metronidazole treatment failure in mild-to-moderate Clostridium difficile infection

Abstract: (CRP) is a useful predictor of metronidazole treatment failure in mild-to-moderate C. difficile infection.

Cited by 8 publications

References 16 publications

Measuring both procalcitonin and C-reactive protein for a diagnosis of sepsis in critically ill patients

Measuring both procalcitonin and C-reactive protein for a diagnosis of sepsis in critically ill patients

Clostridium Difficile Infection and Biliary Obstruction

Clostridium difficile Infection Risk Factors and Outcomes Among Inpatients Infected with NAP1/BI/027 Strain Compared to Non-NAP1 Strain in a Major Chinese Hospital

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