Point-of-care procalcitonin for early detection of bacterial coinfection in patients with severe dengue admitted to the intensive care units

Abstract

Background: Early detection of bacterial coinfection in severe dengue remains challenging. Point-of-care (POC) procalcitonin (PCT) may be used for this role, but it needs to be investigated. We evaluated the performance of POC PCT for early detection of bacterial coinfection in patients with severe dengue admitted to the intensive care units (ICU).
 Methodology: In this cross-sectional study, we analyzed PCT level in severe dengue patients with and without bacterial coinfection upon their ICU admission. The diagnostic efficacy of PCT for the coinfection was determined through analysis of the receiver operating characteristics (ROC) curve.
 Results: Fifty patients with severe dengue were enrolled over a one-year period. Fourteen (28.0%) of these patients had bacterial coinfection on ICU admission. PCT was significantly higher in patients with the coinfection than those without (36.2 ± 41.8 vs 3.6 ± 5.6 ng/mL, P = 0.012). The Area Under the Curve (AUC) of 0.768, ideal cut-off of more than 4.6 ng/mL, sensitivity of 64.3% and specificity of 83.3% revealed that PCT was a good marker for detecting bacterial coinfection in our severe dengue cohort.
 Conclusion: Point-of-care procalcitonin provides early detection of bacterial coinfection with a good performance in patients with severe dengue; however, larger studies are warranted to validate these findings with quantification.
 Abbreviations: APACHE - Acute Physiological and Chronic Health Evaluation; AUC - Area Under the Curve; CRP - C-reactive protein; ICU - intensive care unit; POC - Point-of-care; PCT – procalcitonin; ROC - receiver operating characteristics curve
 Key words: Procalcitonin; Coinfection; Severe Dengue; Intensive Care Units
 Citation: Azmi WNAW, Shukeri WFWM, Nor MBM, Ramly NF, Seevaunnatum P. Point-of-care procalcitonin for early detection of bacterial coinfection in patients with severe dengue admitted to the intensive care units. Anaesth. pain intensive care 2022;26(4):523-529; DOI: 10.35975/apic.v26i4.1960
 Received: January 02, 2022; Reviewed: May 12, 2022; Accepted: July 12, 2022