Abstract
Procalcitonin (PCT) levels can distinguish between infectious and non-infectious systemic inflammatory response. However, there are some differences between Gram-negative (G−), Gram-positive (G+), and fungal bloodstream infections, particularly in different cytokine profiles, severity and mortality. The aim of current study was to examine whether PCT levels can serve as a distinguishing mark between G+, G−, and fungal sepsis as well. One hundred and sixty-six septic patients with positive blood cultures were examined on C-reactive protein (CRP) and PCT on the same date of blood culture evaluation. The median (interquartile range, IQR) of CRP and PCT in G+, G−, and fungal cohorts and comparison of measured values between groups were made using the Kruskal–Wallis test with subsequent Bonferroni’s corrections, with p < 0.05. In 83/166 (50 %) of blood cultures, G+ microbes, 78/166 (47 %) G− rods, and 5/166 (3 %) fungi were detected. PCT concentrations (ng/ml) were significantly higher in G− compared to other cohorts: 8.90 (1.88; 32.60) in G−, 0.73 (0.22; 3.40) in G+, and 0.58 (0.35; 0.73) in fungi (p < 0.00001). CRP concentrations did not differ significantly in groups. Significantly higher PCT levels could differentiate G− sepsis from G+ and fungemia. In contrast to CRP, PCT is a good discriminative biomarker in different bloodstream infections.
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This work was supported by the Research Program P25 of Charles University in Prague.
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Brodská, H., Malíčková, K., Adámková, V. et al. Significantly higher procalcitonin levels could differentiate Gram-negative sepsis from Gram-positive and fungal sepsis. Clin Exp Med 13, 165–170 (2013). https://doi.org/10.1007/s10238-012-0191-8
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DOI: https://doi.org/10.1007/s10238-012-0191-8