The clinical significance of procalcitonin to identifying microorganism strains in ICU patients with bloodstream infection
10.3760/cma.j.issn.1671-0282.2013.07.021
- VernacularTitle:降钙素原在鉴别重症监护病房血流感染患者菌种中的作用
- Author:
Miaoyun WEN
;
Ming FANG
;
Yiyu DENG
;
Hongke ZENG
- Publication Type:Journal Article
- Keywords:
Procalcitonin;
ICU;
Bloodstream infection;
Microorganism types
- From:
Chinese Journal of Emergency Medicine
2013;22(7):783-786
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the level of serum procalcitonin (PCT) for exploring the clinical value in identifying microorganism strains in the intensive care unit (ICU) patients with blood stream infections.Methods A retrospective analysis of patients with positive blood culture of a single strain and with serum PCT levels detected simultaneously was carried out from January 2010 through December 2012.The comparisons of PCT levels were done among Gram-negative (G-) bacteria,Gram-positive (G +) bacteria and fungi in patients with bloodstream infections.The diagnostic performance of PCT was determined by the receiver operating characteristic curve (ROC).Results A total of 524 patients with blood stream infection were enrolled and categorized into three different groups,namely G-bacteria infection group (n =206),G + bacteria infection group (n =276),and fungi infection group (n =42).The median value of PCT level of G-bacteria group was 14.9 ng/ml,which was significantly higher than that of the other two groups with 0.14 ng/ml and 1.76 ng/ml,respectively (P ＜ 0.01).Further,the PCT level of fungi group also obviously higher than that of G + bacteria group (P ＜ 0.001).According to ROC,PCT level at 2.11 ng/ml could distinguish G-bacteria infection from G + bacteria infection with sensitivity 82.8％ and specificity 80.1％,while PCT at 5.09 ng/ml was used to distinguish G-bacteria infection from fungi infection with sensitivity 68％ and specificity 73.8％.The area under the ROC of G + bacteria and fungi was 33.0％ (P ＜ O.01).Conclusions Serum PCT level is valid for distinguishing ICU patients with blood stream infection caused by G-bacteria from G+ bacteria or from fungi,but the validity of PCT for distinguishing G + bacteria from fungi infection needs to be set up by further studies.
