الفهرس 
Introduction & aim of the studyOnly 14 pages are availabe for public view
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Abstract
One of the most common and serious complications in cirrhotic patients is bacterial infection (144).Bacterial infections are known to be important causes of high mortality and morbidity in such patients(145).
In our study we aim to evaluate the validity of CRP and PCT in prediction of bacterial infection in cirrhotic patient. This study was conducted on cirrhotic patients following admission, and the following variables were collected: age, gender, etiology of cirrhosis , prophylactic antibiotics. All subjects underwent laboratory evaluation at admission, and the following tests were performed for this study: CBC , renal function , complete liver function, blood culture , CRP and PCT. Individuals with suspected infection at hospital admission were submitted to clinical examination and laboratory analysis (culture) to confirm this diagnosis and to establish the primary source of infection.
The diagnosis of systemic inflammatory response syndrome (SIRS) and sepsis was established based on the definition of the Society Of Critical Care Medicine (SCCM). Severity of liver disease was estimated by the Child-Pugh score and MELD (Model for End-Stage Liver Disease) calculated based on laboratory tests performed on admission.
CRP and PCT measurements were performed on samples collected on hospital admission. The serum procalcitonin level was assessed by Electro Chemi Luminescence Immuno Assay (Eclia). and C-Reactive Protein level was assessed by Immuno Turbido Metric Assay
And from our study we found that from 90 consecutive hospitalized cirrhotic patients 42 patients were clinically infectious and 48patients were clinically non infectious and most common infection was chest infection(80.7%) followed by SBP(47%) &urinary tract infection(21%) &dermal(12%) and gastroenteritis(7%) in both groups.
The levels of TLC ,CRP and procalcitonin were significantly higher in infectious group than non infectious group
Blood culture was positive in 100% of patients in group 1(clinically infectious) , while positive in 6.3% of patients in group 2 (clinically non infectious)
And The mean level of CRP was high in patients with positive blood cultures compared to patients with negative blood culture ( 13.4 vs. 3.2). Also The mean level of procalcitonin was high in patients with positive blood cultures compared to patients with negative blood culture ( 339.8 vs. 288)
And we found that a cutoff CRP level >4.6 mg/L indicated the presence of infection with a sensitivity of 97.78%, a specificity of 95.56%. As regard procalcitonin the probability of infection in cirrhotics was estimated with the level >347 indicated the presence of infection with a sensitivity of 37.78%, a specificity of 100%
Also we found that the incidence of bacterial infection increased in those with higher meld and child score(Band C).