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OBJECTIVES: To identify patterns in inflammatory marker and vital sign responses in adult with suspected bloodstream infection (BSI) and define expected trends in normal recovery. METHODS: We included patients ≥16 y from Oxford University Hospitals with a blood culture taken between 1-January-2016 and 28-June-2021. We used linear and latent class mixed models to estimate trajectories in C-reactive protein (CRP), white blood count, heart rate, respiratory rate and temperature and identify CRP response subgroups. Centile charts for expected CRP responses were constructed via the lambda-mu-sigma method. RESULTS: In 88,348 suspected BSI episodes; 6908 (7.8%) were culture-positive with a probable pathogen, 4309 (4.9%) contained potential contaminants, and 77,131(87.3%) were culture-negative. CRP levels generally peaked 1-2 days after blood culture collection, with varying responses for different pathogens and infection sources (p 

Original publication




Journal article


J Infect

Publication Date





Bloodstream infection, C-reactive protein, Centile chart, Trajectory subgroups, Vital signs, Humans, Male, Female, C-Reactive Protein, Middle Aged, Aged, Biomarkers, Adult, Vital Signs, Sepsis, Young Adult, Leukocyte Count, Heart Rate, Inflammation, Aged, 80 and over, Respiratory Rate, Adolescent, Bacteremia, Blood Culture, Body Temperature