Procalcitonin better than C-reactive protein, erythrocyte sedimentation rate, and white blood cell count in predicting DNAemia in patients with sepsis.

Christian Leli, Angela Cardaccia, Marta Ferranti, Angelica Cesarini, Francesco D'Alò, Carla Ferri, Elio Cenci, Antonella Mencacci
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引用次数: 25

Abstract

Background: Procalcitonin (PCT) levels can be used to predict bacteremia and DNAemia in patients with sepsis. In this study, the diagnostic accuracy of PCT in predicting blood culture (BC) results and DNAemia, as detected by real-time PCR (RT-PCR), was compared with that of other markers of inflammation commonly evaluated in patients with suspected sepsis, such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count.

Methods: A total of 571 patients for whom BC, blood RT-PCR, PCT, CRP, ESR, and WBC count were requested for laboratory diagnosis of sepsis were included in the study. Receiver operating characteristic curve analysis was performed to compare the ability of the above biomarkers to predict BC and blood RT-PCR results.

Results: A total of 108 pathogens were identified by BC (79 pathogens, 14.5% positive rate) and/or RT-PCR (90 pathogens, 16.5% positive rate), after exclusion of 26 contaminated samples. The PCT areas under the curve (AUCs) in predicting BC (0.843; 95% CI 0.796-0.890; p < 0.0001) and RT-PCR (0.916; 95% CI 0.888-0.945; p < 0.0001) results were significantly greater than AUCs found for CRP, ESR, and WBC count.

Conclusions: PCT showed a better diagnostic accuracy than CRP, ESR, and WBC count in predicting DNAemia and bacteremia in patients with suspected sepsis.

降钙素原比c反应蛋白、红细胞沉降率和白细胞计数更能预测脓毒症患者的dna血症。
背景:降钙素原(PCT)水平可用于预测脓毒症患者的菌血症和dna血症。本研究将实时荧光定量PCR (RT-PCR)检测的PCT预测血培养(BC)结果和dna血症的诊断准确性与疑似脓毒症患者常用的其他炎症标志物(如c反应蛋白(CRP)、红细胞沉降率(ESR)和白细胞(WBC)计数)进行比较。方法:选取571例脓毒症实验室诊断要求BC、RT-PCR、PCT、CRP、ESR和WBC计数的患者作为研究对象。进行受试者工作特征曲线分析,比较上述生物标志物预测BC和血液RT-PCR结果的能力。结果:在排除污染样品26份后,BC法(79份,阳性率14.5%)和/或RT-PCR法(90份,阳性率16.5%)共检出病原菌108份。PCT曲线下面积(auc)预测BC (0.843;95% ci 0.796-0.890;p < 0.0001)和RT-PCR (0.916;95% ci 0.888-0.945;p < 0.0001)的结果明显大于CRP、ESR和WBC计数的auc。结论:PCT在预测疑似脓毒症患者dna血症和菌血症方面的诊断准确性优于CRP、ESR和WBC计数。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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