A comparison of eosinopenia and C-reactive protein as a marker of bloodstream infections in critically ill patients: a case control study

Anaesth Intensive Care. 2009 May;37(3):450-6. doi: 10.1177/0310057X0903700319.

Abstract

Diagnosis of bloodstream infections in critically ill patients is difficult. This case control study involved a total of 22 patients with confirmed bloodstream infections and 44 concurrent controls from an intensive care unit in Western Australia. We aimed to assess whether eosinopenia and C-reactive protein are useful markers of bloodstream infections in critically ill patients. The patients with bloodstream infections had a more severe disease and a longer length of intensive care unit (10.7 vs 4.0 days, P = 0.001) and hospital stay (40.9 vs 17.9 days, P = 0.015) than the controls. Univariate analyses showed that C-reactive protein (area under the receiver operating characteristic curve 0.847, 95% confidence interval (CI) 0.721 to 0.973), eosinophil counts (area under the receiver operating characteristic curve 0.849, 95% CI 0.738 to 0.961) and fibrinogen concentrations (area under the receiver operating characteristic curve 0.730, 95% CI 0.578 to 0.882) were significant markers of bloodstream infections. C-reactive protein concentration was, however the only significant predictor in the multivariate analysis (odds ratio 1.21 per 10 mg/l increment, 95% CI 1.01 to 1.39, P = 0.007). C-reactive protein concentration appears to be a better marker of bloodstream infections than eosinopenia in critically ill patients. A large prospective cohort study is needed to assess whether eosinopenia is useful in addition to C-reactive protein concentrations as a marker of bloodstream infections.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Area Under Curve
  • Biomarkers / metabolism
  • C-Reactive Protein / metabolism*
  • Case-Control Studies
  • Critical Illness*
  • Databases, Factual
  • Eosinophils / metabolism*
  • Female
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Multivariate Analysis
  • ROC Curve
  • Sepsis / diagnosis*
  • Sepsis / physiopathology
  • Severity of Illness Index
  • Western Australia / epidemiology

Substances

  • Biomarkers
  • C-Reactive Protein