SERUM PROCALCITONIN: ITS ROLE IN DIFFERENTIATING GRAM NEGATIVE FROM GRAM POSITIVE AND FUNGAL SEPSIS

  • Syed Faisal Andrabi
  • Sadia Lanker
  • Mohammed Thaha
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S. F. . Andrabi, S. . Lanker, and M. . Thaha, “SERUM PROCALCITONIN: ITS ROLE IN DIFFERENTIATING GRAM NEGATIVE FROM GRAM POSITIVE AND FUNGAL SEPSIS”, ijmhs, vol. 11, no. 06, pp. 1722–1730, Jun. 2021.
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Abstract

Background: Serum procalcitonin (PCT) levels differ in patients with bacterial or fungal infections and are high in patients with Gram?negative sepsis. We evaluated the diagnostic accuracy of serum procalcitonin to discriminate sepsis caused by different pathogens.

Materials and Methods: We included 308 episodes of bacteremia from 282 patients with sepsis and 26 patients with suspected sepsis in this study. Medical records of patients who had bacteremia caused by Gram?negative bacteria (Gram?negative), Gram?positive bacteria (Gram?positive) or fungi were reviewed, and information about PCT was recorded. The diagnostic performance of serum procalcitonin was calculated via receiver operating characteristic (ROC) curves.

Results: Serum PCT levels in Gram?negative, Gram?positive, and fungal sepsis were 7.47 (interquartile range [IQR]: 1.09–41.26) ng/mL, 0.48 (IQR: 0.15–2.16) ng/mL, and 0.60 (IQR: 0.14–2.06) ng/mL, respectively (P < 0.001). ROC analysis revealed an optimal cut?off value of 2.44 ng/mL for PCT in discriminating Gram?negative sepsis from Gram?positive sepsis, which yielded a sensitivity of 68.4% and a specificity of 77.1%. An optimal cut?off value of 3.11 ng/mL for PCT in discriminating Gram?negative sepsis from fungal sepsis, led to a sensitivity of 63.9% and specificity of 93.3%. PCT could not be used to distinguish between Gram?positive and fungal sepsis.

Conclusion: Serum PCT levels were significantly higher in patients with Gram?negative sepsis than in those with Gram?positive or fungal sepsis. PCT is a potential sensitive biomarker for distinguishing Gram?negative sepsis from Gram?positive and fungal sepsis.

Key words: Fungi, Gram?negative bacteria, procalcitonin, sepsis

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