Procalcitonin (PCT) As A Promising Marker For Diagnosis and Differentiation of Bacterial Infections

Abstract

Background: Bacteremia is a life-threatening infection whose prognosis is highly dependent on early recognition and treatment with appropriate antibiotics. Early identification of bacterial infection in patients with fever is important for prompt treatment. However, the available parameters such as C-reactive protein (CRP) and leukocyte counts are not very specific. This study was aimed to assess the diagnostic value of procalcitonin (PCT) and cholesterol for bacterial infection in febrile patients. Procalcitonin levels have been shown to distinguish between bacteremia and noninfectious inflammatory states accurately and quickly in critically ill patients. Also a decrease in plasma lipids occurs during severe sepsis and has prognostic implications in critical illness. Methods: Review of the medical records of every patient treated between May, 2014 and May, 2015 who had bacteremia caused by either Gram positive (GP) or Gram negative (GN) bacteria, and whose PCT, WBCs, CRP and cholesterol levels were measured at the onset of infection Results: 88 episodes of either GN bacteremia (n = 56) or GP bacteremia (n = 32) were included. Procalcitonin levels were found to be markedly higher in patients with GN bacteremia than in those with GP bacteremia. TLC, CRP, PCT were significantly increased, while cholesterol was significantly decreased in cases when compared to control group. Conclusion: In a critically ill patient with clinical sepsis, GN bacteremia could be associated with higher PCT values than those found in GP bacteremia, regardless of the severity of the disease. Low lipid levels, particularly low Cholesterol, pointed to bacterial infection Reflecting the severity of disease, plasma lipid levels may be a complementary tool in the diagnostic workup of patients with septicemia.