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Year : 2017  |  Volume : 2  |  Issue : 4  |  Page : 1-6

C-reactive protein and resistin detect bacterial infection in liver cirrhosis

1 Department of Internal Medicine, Sint Carolus Hospital, Jakarta, Indonesia
2 Division of Gastroentero-hepatology, Department of Internal Medicine, Medical Faculty University of Udayana/ Sanglah General Hospital, Denpasar, Indonesia

Correspondence Address:
Hendra Koncoro
Department of Internal Medicine, Sint Carolus Hospital, Jakarta
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Source of Support: None, Conflict of Interest: None

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Background: Bacterial infection is related with poor outcome, but often full of diagnostic difficulties in cirrhotic patients. The role of clinical parameters such as systemic inflammatory response syndrome, leukocyte count, neutrophil count, and other markers remains unclear in liver cirrhosis patients. Aim: The aim of this study was to evaluate the usefulness of inflammatory markers and determined which markers were best for the diagnosis of infection in decompensated cirrhotic patients. Methods: This was a diagnostic study consisted of 80 cirrhotic patients admitted to Sanglah general hospital, Denpasar from August 2014 until July 2015. The presence of infection was evaluated. Markers of infection consist of leukocyte count, neutrophil count, neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP) and resistin were measured. Accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were determined. Results: Twenty patients (25%) had bacterial infections and spontaneous bacterial peritonitis (SBP) was the most common infections occurred. NLR, CRP, and resistin were higher in bacterial infections group (p < 0.05). Multiple logistic regression analyses showed that CRP and resistin were predictive factor for occurrence of bacterial infections (p < 0.05). For the diagnosis of infection, baseline CRP – using a 11.65 mg/L cut-off value - and resistin – using a 13 ng/mL cut-off value - generated area under the receiver operating characteristic (ROC) curve of 0.796 and 0.787, respectively. The sensitivity, specificity, PPV, and NPV for CRP were 90%, 73%, 52.9%, and 95.7%, respectively. For resistin, the sensitivity, specificity, PPV, and NPV were 90%, 59%, 41.9%, and 94.6% respectively. Conclusions: The present study suggests moderate to high accuracy for CRP and resistin as a diagnostic aid for bacterial infections in liver cirrhosis.

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