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Procalcitonin and C-reactive protein in early diagnosis of sepsis caused by either Gram-negative or Gram-positive bacteria

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Abstract

Background

Sepsis is the most frequent cause of systemic inflammatory response syndrome (SIRS). Procalcitonin (PCT) and C-reactive protein (CRP) are well-known predictors of sepsis. Serum PCT levels are associated with blood culture positivity in patients with sepsis, but the magnitude of elevation of PCT and CRP levels at the onset of sepsis is unknown in Gram-negative (GN) bacteremia and in Gram-positive (GP) bacteremia.

Aims

To evaluate the PCT and CRP levels in 72 h at the onset of sepsis in GN and GP bacteremia.

Methods

We retrospectively analyzed the data from 648 blood-positive specimens from three integrated teaching hospitals in Xiamen, China. One hundred and forty-seven adult patients with sepsis within 72 h enrolled in the study. Serum PCT and CRP level were assessed according GN or GP bacteremia.

Results

A total of 147 (22.68 %) patients were eligible for inclusion in the study, including 56 GP sepsis and 91 GN sepsis. PCT, but not CRP levels, was significantly higher in patients in the GP group than in the GN group (23.64 vs 6.18 ng/mL, p < 0.001). The area under the receiver-operating characteristic (ROC) curve of PCT was 0.73 (95 % confidence interval 0.65–0.81) and that under the ROC curve of CRP was 0.52 (95 % confidence interval 0.43–0.62). A positive predictive value of 72.5 % and a negative predictive value of 67.9 % were achieved with a PCT cutoff value of 2.1 ng/ml.

Conclusion

Serum PCT levels are higher in GN sepsis than GP sepsis in 72 h. There are not differences in CRP. The separation of PCT and CRP phenomenon is helpful for early diagnosis of GP sepsis.

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Acknowledgments

We sincerely thank Xiao Mei Liu, Lin Hui Zhan, Jin Chen, MD, Xiao Yan Zhao, Yi Yang, and Hao Xu for their assistance provided during the study.

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Authors and Affiliations

  1. Southern Medical University, Guangzhou, China

    H. H. Liu & L. Su

  2. Department of Emergency, Zhongshan Hospital, Xiamen University, Xiamen, China

    H. H. Liu & J. Li

  3. General Surgery Department, Haicang Hospital, Xiamen, China

    J. B. Guo

  4. Department of Intensive Care Unit, General Hospital of Guangzhou Military Command, Guangzhou, China

    H. H. Liu & L. Su

  5. Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, China

    M. W. Zhang

Authors
  1. H. H. Liu
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  2. M. W. Zhang
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  4. J. Li
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  5. L. Su
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Corresponding author

Correspondence to L. Su.

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Conflict of interest

Hui Heng Liu declares that she has no conflict of interest. Min Wei Zhang declares that he has no conflict of interest. Jiu Bing Guo declares that he has no conflict of interest. Juan Li declares that she has no conflict of interest. Lei Su declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethical Committee of the Zhongshan Hospital of Xiamen University.

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Liu, H.H., Zhang, M.W., Guo, J.B. et al. Procalcitonin and C-reactive protein in early diagnosis of sepsis caused by either Gram-negative or Gram-positive bacteria. Ir J Med Sci 186, 207–212 (2017). https://doi.org/10.1007/s11845-016-1457-z

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  • DOI: https://doi.org/10.1007/s11845-016-1457-z

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