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Diagnostic Accuracy of Proclacitonin Compared to C-Reactive Protien in Recognizing Bacteremia Determined by Blood Culture
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| Author:
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KHALID KHALIL ALAARAJI, RIADH A.HENWA, DHUFFER SHEHAB QASIM
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| Abstract:
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Background: One of the most life-threatening events that needs early and definite diagnosis to start sooner appropriate treatment as antibacterial is bloodstream infections (as bacteremia or sepsis) to prevent and reduce short and long term outcome and complications and to decrease the mortality rate which may related to insult to a various systemic organs of the body. The main presentation of bloodstream infections is fever which is suggested when there is increased body temperature =38°C (100.4°F) that is best measured rectally.
Depending on accurate medical history and appropriate examination to detect the focus of infection can reach to professional diagnosis of some type of simple infection in the significant number of children. Unfortunately, the infectious diseases may have unclear or nonspecific clinical features and may present with fever only in few number of patients, especially in infants, and even a carful clinical examination may fail to discover the focus of infection. So is very important to recognize as early as possible the bacterial infection (to receive early and appropriate treatment, to avoid overuse of antibiotics, to decrease organism resistance, and to prevent complication which lead to improvement of outcomes) which depend on identification of biomarkers that are related to bacterial infections.
Aims of the Study: (1) The utility of procalcitonin and C- reactive protein as early markers of bacterial infection without waiting for blood culture results.
(2) The accuracy of procalcitonin compared to C-reactive protein in recognizing bacterial infection in children.
Methods: This prospective study was conducted in Karbala teaching hospital for children, holly Karbala, Iraq. In the period from May,1, 2019 to December, 31, 2019. The study population consists of 107 children with febrile illness seen in Karbala teaching hospital for children. The age ranged from 1 month to 5 years old.
All children were included in this study had the following investigations: white blood cells count with differential, determination of C- reactive protein and procalcitonin value, and blood for culture
Results: From 107 patients in this study 47 (43.9%) patients were female and 60 (56.1%) patients were male. Regarding blood culture the results were 83 (77.6%) with no growth of bacteria, 12 (11.2%) streptococcus pneumonia, 5 (4.7%) salmonella, 4 (3.7%) staph aureus, and 3 (2.8%) E. coli.
Furthermore, the results show that sensitivity and specificity of C-reactive protein and procalcitonin for the diagnosis of bacterial infection had changes as cut-off ranges of these biomarkers increasing, as sensitivity and specificity when CRP = 20 mg/dl, 89.5%, 23% respectively that became 63.2%, 72% respectively at CRP cutoff = 83mg/dl. While for procalcitonin, sensitivity and specificity were 100%, 53% respectively at = 0.5 ng/ml that change to 26%, 98% respectively at cutoff = 2 ng/ml.
Finally, the area under the curve (AUC) of the CRP was 0.708, so the CRP consider a fair marker for diagnosis bacterial infection while the area under the curve (AUC) of the procalcitonin was very large 0.920, so it consider a good marker for differentiating bacterial from non-bacterial infection
Conclusions: (1) PCT and CRP are consistent with blood culture as diagnostic biomarkers for bacterial infection.
(2) PCT showed a higher diagnostic accuracy compared to CRP in bacterial infection.
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| Keyword:
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Reactive protein,proclacitonin
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| EOI:
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-
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| DOI:
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https://doi.org/10.31838/ijpr/2020.12.04.639
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| Download:
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