CRP/CD11b ratio: a novel parameter for detecting gram-positive sepsis

Hum Immunol. 2009 Apr;70(4):237-43. doi: 10.1016/j.humimm.2009.01.009. Epub 2009 Jan 23.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Blood Sedimentation
  • C-Reactive Protein / analysis*
  • CD11b Antigen / blood*
  • Diagnosis, Differential
  • Flow Cytometry
  • Gram-Negative Bacterial Infections / blood
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Positive Bacterial Infections / blood
  • Gram-Positive Bacterial Infections / diagnosis*
  • Humans
  • Neutrophils / metabolism
  • Receptors, Complement 3b / blood
  • Sensitivity and Specificity
  • Sepsis / blood
  • Sepsis / diagnosis*

Substances

  • CD11b Antigen
  • Receptors, Complement 3b
  • C-Reactive Protein