Asian Journal of Microbiology, Biotechnology & Environmental Sciences Paper

EVALUATION OF PROCALCITONIN LEVEL AS A PROGNOSTIC AND DIAGNOSTIC MARKER FOR THE ONSET OF SEPSIS THERAPY

ALIAKBAR KEYKHA, SOROOSH DABIRI, ALIREZA DASHIPOUR AND ALIREZA RAHAT DAHMARDEH

Abstract

Sepsis is one of the leading causes of mortality in patients admitted to the intensive care unit, and time is important in its diagnosis; however, long time is spent to prepare a blood culture result. Therefore, this study aimed to investigate procalcitonin (PCT) level as a diagnostic marker to initiate the treatment of sepsis. This analytical cross-sectional study was performed on 80 patients suspected of sepsis. Blood samples were collected three times to measure PCT level. Tracheal blood, urine and wound culture and white blood cells (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) were also performed. The results were then analyzed to assess the correlation, sensitivity, specificity, positive and negative predictive values. Positive and negative blood culture was observed in 17 (21.2%) and 63 (78.8%) patients, respectively. Positive and negative urine culture was found in 17 (21.2%) and 63 (78.8%) patients, respectively. Positive and negative tracheal secretions culture was seen in 44 (55%) and 36 (45%) patients, respectively. PCT levels at T1 were weakly correlated with positive CRP and negative ESR, WBC and strongly correlated with the positive blood culture. The PCT levels at T2 and T3 were weakly correlated with all positive tests except blood culture, with which T2 and T3 respectively had strong positive and weak positive correlation. The sensitivity and negative predictive value of the test was 100% at the cut-off point of 0.5ng/dl, but its specificity and predictive positive value were low. The best cut-off point was 1.1ng/dl, in which the sensitivity and specificity of the test were 85.7 and 47.1, respectively. Considering its high sensitivity, high PCT levels can be used as an appropriate test for the diagnosis and timely and appropriate antibiotic treatment of sepsis.