The use of C-reactive protein in predicting bacterial co-Infection in children with bronchiolitis

Abstract

Background:Bronchiolitis is a potentially life-threatening respiratory illness commonly affecting children who are less than two years of age. Patients with viral lower respiratory tract infection are at risk for co-bacterial infection.Aim:The aim of our study was to evaluate the use of C-reactive protein (CRP) in predicting bacterial co-infection in patients hospitalized for bronchiolitis and to correlate the results with the use of antibiotics.Patients and Methods:This is a prospective study that included patients diagnosed with bronchiolitis admitted to Makassed General Hospital in Beirut from October 2008 to April 2009. A tracheal aspirate culture was taken from all patients with bronchiolitis on admission to the hospital. Blood was drawn to test C-reactive protein level, white cell count, transaminases level, and blood sugar level.Results:Forty-nine patients were enrolled in the study and were divided into two groups. Group 1 included patients with positive tracheal aspirate culture and Group 2 included those with negative culture. All patients with a CRP level ≥2 mg/dL have had bacterial co-infection. White cell count, transaminases and blood sugar levels were not predictive for bacterial co-infection. The presence of bacterial co-infection increased the length of hospital stay in the first group by 2 days compared to those in the second group.Conclusion:Bacterial co-infection is frequent in infants with moderate to severe bronchiolitis and requires admission. Our data showed that a CRP level greater than 1.1 mg/dL raised suspicion for bacterial co-infection. Thus, a tracheal aspirate should be investigated microbiologically in all hospitalized patients in order to avoid unnecessary antimicrobial therapy and to shorten the duration of the hospital stay.

Antibiotic resistance in sepsis patients: Evaluation and recommendation of antibiotic use

“…[2120] As a sepsis marker in the neonatus, procalcitonin is better than C-Reactive Protein (CRP);[21] however, CRP can be used as a marker for bacterial co-infection in the viral-induced bronchiolitis infant populations. [22]…”

Evaluating serum C-reactive protein level in patients with chronic obstructive pulmonary disease – A cross-sectional study

“…Gan and colleagues aggregated data from five cross-sectional studies and estimated an average mean increase in serum CRP of 1.85 mg/L in individuals with stable COPD [9]. There were similar results in the study conducted by Fares M et al [10]. They showed that CRP level >1.1mg/L in infants with bronchiolitis.…”

Importance of Respiratory Syncytial Virus as a Predictor of Hospital Length of Stay in Bronchiolitis

“…Several predictive models had reports consistently the chest indrawing as predictive of prolonged LOS that is which is biologically plausible and expected due that this sign also is a universal marker of severity of the disease, as well as the presence of underlying conditions (congenital heart disease, chronic lung conditions, immunocompromised states) (3,(6)(7)(8)(20)(21)(22) or C-reactive protein (CRP) as a biomarker of severity and bacterial co-infection in patients hospitalized for bronchiolitis (23)(24)(25) Our study has limitations. First, since this study was based on medical records review, we cannot include other variables such as environmental pollution and genetic factors, and residual confounding cannot be excluded.…”