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C-reactive protein misdiagnoses delayed postoperative spinal implant infections in patients with low-virulent microorganisms

European Spine Journal Feb 07, 2019

Akgun D, et al. - From January 2013 through January 2016, researchers estimated 257 candidates to build the cutoff values to diagnose delayed postoperative spinal implant infections (PSII) based on serum C-reactive protein (CRP). They noticed a significant difference in serum CRP levels between septic and aseptic cohorts ie, 19.3 vs 4.8 mg/l. About 43% of cases from the PSII group had a normal (< 5 mg/l) serum CRP level former to revision surgery. They found Propionibacterium spp. (most common isolated microorganism) followed by coagulase-negative staphylococci. Overall, serum CRP revealed low sensitivity and specificity for the diagnosis of delayed PSII due to high incidence of low-virulent pathogens.
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