IS PROCALCITONIN AN ACCURATE MARKER IN THE DIAGNOSIS OF ACINETOBACTER-INDUCED BACTEREMIA?

Abstract

Nosocomial bloodstream infections are common in intensive care units, and a significant portion results in mortality. Procalcitonin is a biomarker used in the early diagnosis of bloodstream infections. Since different pathways release it, its level in the blood may differ in bloodstream infections caused by different agents. The present study was designed to demonstrate whether procalcitonin was an accurate marker in nosocomial bloodstream infections caused by Acinetobacter spp. The present study evaluated 214 bacteremia episodes of 145 patients diagnosed with nosocomial bloodstream infection. Nosocomial bloodstream infection agents were divided into four groups gram-positive bacteria, gram-negative bacteria, Acinetobacter spp., and Candida spp. At the time of diagnosis, procalcitonin, C-reactive protein, neutrophil/lymphocyte ratio, and leukocyte values were measured on the 3rd and 7th days. The mean procalcitonin value measured at the time of diagnosis was 11.7±21.8 ng/ml, the highest in the gram-negative bacteria group. The mean procalcitonin value in the gram-positive bacteria group was 2.8±6.44 ng/ml, 2.5±3.35 ng/ml in the Candida spp. group, and 3.5±12.1 ng/ml in the Acinetobacter spp. group. A significant difference was determined between the four groups regarding procalcitonin values. It was determined that the blood procalcitonin level at the time of diagnosis did not increase as expected in Acinetobacter spp.-induced nosocomial bloodstream infections. In this respect, caution should be exercised in the early diagnosis of nosocomial bloodstream infections.