Clinical significance of procalcitonin in differentiation of bloodstream infections caused by coagulase-negative Staphylococcus from contamination in the Department of Hematology
10.16718/j.1009-7708.2018.01.010
- VernacularTitle:降钙素原鉴别血液科患者凝固酶阴性葡萄球菌血流感染与污染的临床价值
- Author:
Fei YANG
1
;
Chengsen CAI
;
Xianfeng ZHANG
;
Depei WU
;
Aining SUN
Author Information
1. 苏州大学附属第一医院血液科
- Keywords:
procalcitonin;
coagulase-negative Staphylococcus;
bloodstream infection;
hematology patient
- From:
Chinese Journal of Infection and Chemotherapy
2018;18(1):48-52
- CountryChina
- Language:Chinese
-
Abstract:
Objective To examine the value ofprocalcitonin (PCT) in differential diagnosis of bloodstream infections (BSI) caused by coagulase-negative Staphylococcus (CNS) from contamination in Department of Hematology.Methods One hundred and fifty-six patients with bloodstream or intravenous catheter-related CNS infection were included in this study.The patients were treated in Department of Hematology,the First Affiliated Hospital of Soochow University during the period from January 2013 to December 2015.The patients were divided into CNS bloodstream infection group (n=66) and blood culture contamination group (n=90).The two groups were compared in terms of sex,age,diagnosis,length of hospital stay,duration of neutropenia,neutrophil count and lymphocyte count,peak fever,C-reactive protein (CRP) and PCT.The receiver operating characteristic (ROC) curve was plotted with SPSS 21.0 software to analyze the value of PCT in differential diagnosis.Results Age,sex,clinical diagnosis,length of hospital stay,duration of neutropenia,neutrophil count and lymphocyte count did not show significant difference between bloodstream infection group and contamination group (P＞0.05),while peak fever (P＜0.001),CRP (P=0.002) and PCT (P=0.018) were significantly higher in bloodstream infection group than in contamination group.ROC analysis indicated that PCT provided optimal discrimination between these two groups at cnt-offvalue of 0.374 μg/L,with sensitivity of 54.5％ and specificity of 94.4％.The area under the curve (AUC) was 0.830±0.032 (95％ CI:0.767-0.893,P＜0.001).Conclusions PCT may be a good marker for differentiating CNS bloodstream infection from contamination with higher specificity than the commonly used marker CRP.This finding may help clinicians reduce the overuse of antibiotics.
