Infect Chemother.  2003 Oct;35(5):283-288.

Influence of Liver Dysfunction on the Production of C-Reactive Protein in Liver Cirrhosis Patients with Escherichia coli Bacteremia

• Park WB
• Kang CI
• Kim DM
• Lee KD
• Jang HC
• Kim HB
• Oh MD
• Lee HS
• Choe KW

Abstract

BACKGROUND: C-reactive protein (CRP) is an acute phase reactant produced in the liver. To assess the influence of liver dysfunction on the production of CRP, we evaluated CRP response to E. coli bacteremia in patients with or without liver cirrhosis (LC).
METHODS
30 LC patients who developed spontaneous peritonitis with E. coli bacteremia were enrolled in the study. Baseline values of total bilirubin, serum albumin, and prothrombin time were obtained within 2 months prior to infection. Liver dysfunction was categorized according to the Child-Pugh score. 30 patients with E. coli bacteremia who had no underlying liver dysfunction were included as a control group. Matched-control of 30 LC patients without evidence of acute infection was also included. The peak CRP values were compared among the groups.
RESULTS
In the patients with E. coli bacteremia, the mean value of peak CRP was 7.3 (+/- 5.0) mg/dL in LC patients, 17.9 (+/- 8.3) mg/dL in patients without liver dysfunction (p<0.001). In the advanced LC patients with Child-Pugh class C, the level of CRP was 5.2 (+/- 3.3) mg/dL in patients with E. coli bacteremia, 0.5 (+/- 0.4) mg/dL in patients without acute infection (P<0.001). Child-Pugh score had correlation with decrease of CRP (linear regression test, P=0.004).
CONCLUSION
CRP response during E. coli bacteremia was attenuated but maintained even in patients with advanced liver dysfunction.

Keyword

C-reactive protein; Liver cirrhosis; E. coli; Bacteremia

MeSH Terms

Bacteremia*
Bilirubin
C-Reactive Protein*
Escherichia coli*
Escherichia*
Humans
Liver Cirrhosis*
Liver Diseases*
Liver*
Peritonitis
Prothrombin Time
Serum Albumin
Bilirubin
C-Reactive Protein
Serum Albumin