Serum procalcitonin levels of patients with candidemia hospitalized in Intensive Care Units

Abstract

Objective: Fungal infections are a main reason for mortality of critically ill patients in Intensive Care Units (ICUs). Recently, fungal infections have been on rise. Lack of a specific marker for fungal infections has led to some problems in diagnosing these infections. Scant data exist on serum procalcitonin (PCT) levels in high-risk patients with invasive fungal infections, such as ICU patients. Materials and Methods: In this prospective study conducted in 2014–2015 in Al-Zahra Hospital, Isfahan, Iran, 64 people were investigated. The PCT levels of the patients were measured at 0, 24, 48, and 72 h as well as 7 and 14 days of the ICU stay. Moreover, a blood sample was taken from each person every 3 days and examined for positive BACTEC Candida fungal culture. Results: Nine (15%) patients had candidemia. The mean serum PCT level was not significantly different between the patients with and without candidemia at admission and 24, 48, and 72 h of the ICU stay (P > 0.05), but was significantly different on 7 and 14 days of the ICU stay (P < 0.001). Conclusion: This study demonstrated that the serum PCT levels increased significantly in the patients with candidemia hospitalized in ICUs. Therefore, serum PCT, as a marker, can be relied on, in addition to other symptoms and factors, for taking a decision about the initiation of treatment with antifungal drugs. Besides that, further studies with larger sample size are recommended to examine the predictive value of PCT for invasive fungal infections.