DIAGNOSTIC SIGNIFICANCE AND DETERMINATION OF C-REACTIVE PROTEIN (CRP) IN ADULT PATIENTS WITH COMMUNITY ACQUIRED PNEUMONIA

Abstract

Objective: to study the diagnostic significance and determination of serum C-reactive protein (CRP) levels in patients with community acquired pneumonia (CAP) at the time of diagnosis and compared it with CRP of healthy controls. Methodology: This study was conducted from December 2005 to Dec 2009 on 162 adult patients and 30 (males=15, females=15) healthy controls. All microbiological assays were performed according to standardized procedures; whereas CRP was measured in serum samples by an automated turbidimetric method with normal reference of ≤ 5.0 mg/L. Results: A total of 85 patients (52.46%) had an identifiable etiology with bacterial pathogens as the causative agents, 31 (19.31%) had viral origin, 10 (6.17%) had other bacterial pathogens and 36 patients (22.22%) with negative microbiological findings. Mean serum CRP levels were 101±15.60 mg/L, 84.50±12.60 mg/L,76.50±11.60 mg/L and 90.35±11.50 mg/L, 85.10±10.15 mg/L & 79.10±15.20 mg/L for Klebsiella pneumonia, Streptococcus pneumonia, Haemophilus influenzae alone and in combination with other pathogens respectively. Mean serum CRP was 60.45±9.10 mg/L in viral etiology only and 4.10 ± 2.25 mg/L in controls. CRP values were comparable in different etiologic groups of bacterial origin, except Streptococcus pneumoniae and Klebsiella pneumoniae groups (P<0.05), whereas highly significant when compared viral etiology, other pathogens (P<0.01) and negative microbiological findings (P<0.001). Conclusion: In adult patients with CAP and bacterial pneumonic pathogens as the causative agents, serum CRP levels are greater, ranging between 76.50±11.60 to 101±15.60 mg/L and thus seems to predict severity of illness and assisting in deciding the appropriate site of care, whether hospital or home. Key Words: C-reactive protein (CRP), Community-acquired pneumonia (CAP), bacterial pathogens.