Clinical and Bacteriological Relevance of Procalcitonin: A Single Center, Retrospective Observational Study
Romya Singh
Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli Road, Lucknow, Uttar Pradesh 226014, India.
Chinmoy Sahu *
Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli Road, Lucknow, Uttar Pradesh 226014, India.
Sangram Singh Patel
Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli Road, Lucknow, Uttar Pradesh 226014, India.
Nidhi Tejan
Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli Road, Lucknow, Uttar Pradesh 226014, India.
Mohan Gurjar
Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli Road, Lucknow, Uttar Pradesh 226014, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Clinical relevance of procalcitonin levels in cases of sepsis due to different pathogens and the relationship between procalcitonin levels and patient outcome has not been widely studied. The aim of this study is tohighlight the clinical relevance of procalcitonin in sepsis due to various pathogens and in patient prognosis.
Methods: In this retrospective observational study 348 cases of sepsis were analysed and their procalcitonin levels were compared with the different pathogens isolated. The patient outcome as 28 day mortality was also compared with different procalcitonin levels which was divided into four groups (group1: <0.5ng/ml, group 2: 0.5 - < 2ng/ml, group 3: 2 - < 10ng/ml, group 4: >= 10ng/ml).
Results: The procalcitonin levels were significantly higher in cases of sepsis due to Gram negative bacilli (14.5ng/ml ± 2.8) compared to Gram positive cocci (8.59ng/ml ± 1.5) and yeast (2.96ng/ml ± 0.56). Multiple logistic regression showed significant difference between 28-day mortality and Multidrug resistant bacteria (MDR) pathogens (p=0.006) and group 4 procalcitonin (PCT) levels (p=0.033).
Conclusion: The procalcitonin levels were significantly higher in sepsis due to Gram negative bacilli compared to Gram positive cocci, Gram positive bacilli and yeast. The patient clinical outcome observed as 28-day mortality was also higher in group 4 PCT levels (>= 10ng/ml). Thus, we found PCT is a reliable marker for sepsis with Gram negative bacilli and for patient prognosis.
Keywords: Procalcitonin, sepsis, pathogens, marker, 28 day mortality