DOI: http://dx.doi.org/10.18203/2349-3933.ijam20213704

Serum procalcitonin as a biomarker of sepsis

Nyamnyei Konyak, Linda Marangmei, Medo M. Kuotsu, Laishram Chittaranjan Singh, L. Shaini Devi, S. Bhagyabati Devi

Abstract


Background: The overlap of clinical presentation between sepsis and SIRS has presented diagnostic difficulty in these two close common scenarios. Blood culture remains the gold standard for detection of specific micro-organism, the non-availability of culture report early and difficulty in culture of many organisms is a challenge in differentiation of sepsis from its mimickers. Keeping this background, a simple tool is needed to guide sepsis management while awaiting the culture report. Therefore, the present study is conducted to determine the procalcitonin level in the setting suspicious of sepsis and to differentiate it from SIRS. The objective of the study was to determine Serum procalcitonin level as a biomarker of early diagnosis of sepsis and also to differentiate sepsis from severe inflammatory response syndrome.

Methods: Cross sectional study on 79 patients aged above 18 years with suspected sepsis admitted in medicine ward. Serum procalcitonin levels were measured and analysed to look for any association with sepsis.

Results: Culture was positive in 41 patients and 38 patients were procalcitonin positive. The sensitivity, specificity, positive predictive value and negative predictive values of serum procalcitonin were found as 96.68%, 94.74%, 95% and 92.30% respectively.

Conclusions: There was a significant association between serum procalcitonin and culture positivity. Procalcitonin levels was found to have high sensitivity and high positive predictive value which may aid in the early diagnosis and guide initiation of anti-microbial therapy in sepsis.


Keywords


Procalcitonin, Sepsis, SIRS, Positive culture

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References


Rimmelé T, Leli C, Payen D, Cantaluppi V, Marshall J, Gomez H, et al. Immune cell phenotype and function in sepsis. Shock. 2016;45(3):282-91.

Bates DW, Cook EF, Goldman L, Lee TH. Predicting bacteremia in hospitalized patients: a prospectively validated model. Ann Intern Med. 1990;113:495-500.

Muller B, Becker KL, Schachinger H, Rickenbacher PR, Huber PR, Zimmerli W, et al. Calcitonin precursors are reliable markers of sepsis in a medical intensive care unit. Crit Care Med. 2000;28:977-83.

Oberhoffer M, Rubwurm S, Bredle D, Chatzinicolau K, Reinhart K. Discriminative power of inflammatory markers for prediction of tumor necrosis factor-alpha and interleukin-6 in patients with systemic inflammatory response syndrome (SIRS) or sepsis at arbitrary time points. Intensive Care Med. 2000;26:170-4.

Khan AA, Singh R, Singh PK. Diagnostic and prognostic significance of procalcitonin in septicemia. Int J Adv Med. 2017;4(3):630-4.

Lai C, Chen S, Wang C. Diagnostic Value of Procalcitonin for Bacterial Infection in Elderly Patients in the Emergency Department. J Am Geriatric Society. 2010;58:518-22.

Lopes JA, Jorge S, Resina C, Santos C, Pereira A, Neves J et al. Acute kidney injury in patients with sepsis. A contemporary analysis: Int J Infect Dis. 2009;13(2):176-81.

Banks JG, Foulis AK, Ledingham IA, Macsween RN. Liver function in septic shock. J Clin Pathol. 1982;35:1249-52.

Woźnica E A, Inglot M, Woźnica KR. Liver dysfunction in sepsis: Adv Clin Exp Med. 2018;27(4):547-51.

Karlowsky JA, Jones ME, Draghi DC. Thornsberry C,Sahm DF,Volturo GA .Prevalence and antimicrobial susceptibilities of bacteria isolate from blood cultures .Ann Clin Microbiol Antimicrob. 2004;3:7.

Vranic SM, Zatric N, Rebic V, Aljicevic M. The most frequent isolates from outpatients with urinary tract infection. Mater Sociomed. 2017;29(1):17-20.

Cukic V, Hadzic A. The most common detected bacteria in sputum of patients with community acquired pneumonia (CAP) treated in hospital. Med Arch. 2016;70(5):354-8.

Ahmadinejad Z, Dadsetan B, Jalili M, Soudbakhsh A, Rasolinejad M. Evaluation of Serum Procalcitonin in Patients with Systemic Inflammatory Response Syndrome with and without Infection. Acta Medica Iranica. 2009;47(5):383-5.

Patil HV, Patil VC. Comparative study of procalcitonin and C Reactive Protein in patients with sepsis. J Nat ScBiol Med. 2020;11(1):93-9.