Comparison of Diagnostic Utility between Procalcitonin and C-Reactive Protein for the Patients with Blood Culture-Positive Sepsis.
10.3343/kjlm.2009.29.6.529
- Author:
Mina HUR
1
;
Hee Won MOON
;
Yeo Min YUN
;
Kyung Hee KIM
;
Hyun Soo KIM
;
Kyu Man LEE
Author Information
1. Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea. dearmina@hanmail.net
- Publication Type:Original Article ; Comparative Study ; English Abstract
- Keywords:
Procalcitonin;
C-reactive protein;
Sepsis
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Biological Markers/blood;
C-Reactive Protein/*analysis;
Calcitonin/*blood;
Child;
Child, Preschool;
Enzyme-Linked Immunosorbent Assay;
Humans;
Infant;
Infant, Newborn;
Middle Aged;
Nephelometry and Turbidimetry;
Protein Precursors/*blood;
ROC Curve;
Reagent Kits, Diagnostic;
Sensitivity and Specificity;
Sepsis/*diagnosis
- From:The Korean Journal of Laboratory Medicine
2009;29(6):529-535
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Procalcitonin (PCT) is a relatively new marker for bacterial infections, and its diagnostic utility has been variable across the studies. We investigated the diagnostic utility of PCT for the patients with blood culture-positive sepsis, and compared it with that of C-reactive protein (CRP). METHODS: In 1,270 consecutive blood samples, PCT and CRP were simultaneously measured and results were compared according to the five categories of PCT concentrations (<0.05 ng/mL; 0.05-0.49 ng/mL; 0.5-1.99 ng/mL; 2-9.99 ng/mL; > or =10 ng/mL). In 506 samples, they were further analyzed according to the result of blood culture. PCT and CRP were measured using enzyme-linked fluorescent assay (bioMerieux Co., France) and rate nephelometry (Beckman Coulter Co., USA), respectively. Their diagnostic utilities were compared using ROC curves. RESULTS: The mean concentrations of CRP in five categories of PCT were 15.4 mg/L, 42.1 mg/L, 101.2 mg/L, 125.0 mg/L, 167.1 mg/L, respectively (P<0.0001). Both PCT and CRP showed significant differences between the two positive and negative groups of blood culture (PCT, 8.47 vs 2.44 ng/mL, P=0.0133; CRP, 110.48 vs 59.78 mg/L, P<0.0001). The areas under the ROC curves (95% confidence interval) for PCT and CRP were 0.720 (0.644-0.788) and 0.558 (0.478-0.636), respectively, and showed a significant difference (P=0.005). CONCLUSIONS: The diagnostic utility of PCT is superior to that of CRP for the patients with blood culture-positive sepsis. PCT seems to be reliable for sepsis diagnosis, and may provide useful information for the critically ill patients.
