C-reactive protein and total leukocyte count as a marker for the screening of early sepsis

Click here to download the original poster (PDF)

Gaurav Chhabra1, Raghavendra L1, Vikas Gaur1, Amrita Soni2, Shubham Rastogi2, Kensuke Saito2, Takahiro Takeuchi2, Sarman Singh1
1Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India and 2HORIBA India Pvt Ltd.


  • Antibiotic Resistance is a major healthcare problem worldwide.
  • Blind therapy is considered to be the most common reason for antibiotic resistance.
  • Unavailability of lab results before prescription and triage.


Need for study


Source: WHO

Aim and objectives

The aim of the study was to evaluate the usefulness of C-reactive protein and total leukocyte count alone or coupled together as early diagnostic markers of bacterial infections among hospitalised patients.

Material and methods

  • Five hundred and twenty one patients presenting with signs and symptoms of any local infection or sepsis were included in the study.
  • Patients on any antibiotic therapy were excluded from the study.
  • Samples were collected from all the patients for various investigations: Complete hemogram, ESR, C-reactive protein and for culture sensitivity examination.
  • All patients underwent detailed evaluation and following the reports of the culture examinations the patients were divided into two groups as culture positive and culture negative.


Statistical analysis

Data presentation:

  • Continuous variable: Mean± SD
  • Categorical variable: Frequency and percentage


Data analysis:

  • Comparison between groups
  • Categorical variable: Chi-square test/ Fischer-exact test
  • Continuous variable: Student t test/ Wilcoxon rank-sum test


ROC curve analysis

  • To determine the diagnostic utility of test for diagnosis of infections



Figure 1: Study population

Figure 1: Study population

Table 1: Demographic parameters of the study population

ParameterCulture Positive
(n = 87)
Culture Negative
(n = 434)
P value
Sex†Males: 54 (62)
Females: 33 (38)
Males: 318 (73)
Females: 116 (27)

Values expressed as * mean ± SD and † n (%)


Figure 2: Hematologic parameters among the two groups

ParameterCulture Positive
(n = 87)
Culture Negative
(n = 434)
P value
Platelet327.5±187199±99.8< 0.001

Values expressed as mean± SD



Table 3: CRP and leucoyte count among the study population

ParameterCulture PositiveCulture NegativeP value
TLC22.6 (4.6-74.2)6.2 (1.2-42.0)< 0.001
CRP17.6 (4.1-74.1)1.3 (0.2-40)<0.001
Platelet296 (11-899)192 (20-560)<0.001
Granulocytes78 (54- 92)62 (36-81)0.03
Lymphocytes21 (06-42)46 (16-51)< 0.001

Values expressed as Median (Min-Max.)



Figure 2: ROC curve for various parameters

Figure 2: ROC curve for various parameters

Table 4: Area under curve value for various parameters




  • WBC counts and C-reactive protein together constitute a rapid and affordable tool for the diagnosis of bacterial infections before the culture results are available.
  • Differentiation between bacterial infection and non bacterial infection or inflammatory response could help in judicious use of antibiotic treatment.


Download PDF


Sie haben Fragen oder Wünsche? Nutzen Sie dieses Formular, um mit unseren Spezialisten in Kontakt zu treten.