Prognostic Value of Serum Procalcitonin level for the Diagnosis of Bacterial Infections in Critically-ill Patients

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Research Article: Prognostic Value of Serum Procalcitonin level for the Diagnosis of Bacterial Infections in Critically-ill Patients
ผู้เขียน/Author: Apichot So-Ngern, Sombat Leelasupasri, Suvatna Chulavatnatol, Chalermsri Pummangura, Pakwan Bunupuradah, and Preecha Montakantikul
Email: apichot.son@siam.edu
สาขาวิชา/คณะ: คณะเภสัชศาสตร์ มหาวิทยาลัยสยาม กรุงเทพฯ 10160
Department/Faculty Faculty of Pharmacy,  Siam University, Bangkok 10160
Published/แหล่งเผยแพร่ Infection and Chemotherapy September 2019 vol. 51 no. 3

การอ้างอิง/citation (APA 6th)

Apichot So-NgernSombat Leelasupasri, Suvatna Chulavatnatol, Chalermsri Pummangura, Pakwan Bunupuradah, and Preecha Montakantikul. (2019). Prognostic value of serum procalcitonin level for the Diagnosis of Bacterial Infections in Critically-ill Patients. Infection and Chemotherapy, 51(3), 263-273. Retrieved from https://doi.org/10.3947/ic.2019.51.3.263


ABSTRACT

Procalcitonin (PCT) is a diagnostic biomarker for bacterial infections in critically ill patients. However, the cut-off value of PCT for the diagnosis of bacterial infections is unclear and unreliable. This study aimed to determine the optimal cut-off value of PCT for the diagnosis of bacterial infections in critically ill patients.Materials and Methods: We conducted a retrospective study involving 311 adult patients who had been admitted to the medical or surgical intensive care unit for more than 24 hours from 2013 to 2015. At least one blood test for PCT level was performed for all patients within the first 24 hours of suspecting an infection.Results: One hundred and fifty-seven patients had bacterial infections, while 154 did not. Patients with bacterial infections had a significantly higher median PCT level than those without bacterial infections (1.90 ng/mL vs. 0.16 ng/mL, P <0.001). The area under the receiver operating characteristic curve of PCT for discriminating between bacterial and non-bacterial infections was 0.874 (95% confidence interval: 0.834, 0.914; P <0.001). The optimal cut-off value of PCT for differentiating between fevers due to bacterial infections from those due to non-bacterial infections was 0.5 ng/mL, with a sensitivity of 84.7%, specificity of 79.9%, positive predictive value of 81.1%, and negative predictive value of 83.7%.Conclusion:PCT was found to be an accurate biomarker for the diagnosis of bacterial infections among patients admitted to medical and surgical intensive care units. The optimal cut-off value of PCT for the diagnosis of bacterial infections was 0.5 ng/mL.

Keywords: Bacterial infections; Critical illness; Diagnosis; Procalcitonin


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Prognostic Value of Serum Procalcitonin level for the Diagnosis of Bacterial Infections in Critically-ill Patients

Faculty of Pharmacy, Siam University, Bangkok, Thailand

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