Procalcitonin and c-reactive protein: A predictor of bacteremia in sepsis

Introduction and Aim: Sepsis is the primary cause of morbidity and mortality in an intensive care unit (ICU). Early laboratory diagnosis of bacteraemia in sepsis and antibiotic treatment of the infection decreases morbidity and mortality. For the early prediction of bacteraemia in adult sepsis, we tried to evaluate biomarkers like procalcitonin (PCT) and C-reactive protein (CRP). Materials and Methods: This is a prospective observational study, in which 152 samples of clinically suspected sepsis patients were included following a convenience sampling technique. The automated BacTAlert system was used for blood culture. Antibiotic susceptibility of the bacterial isolates, serum procalcitonin, CRP and WBC counts were studied. Results: Among the 152 blood cultures, twenty-two samples showed bacterial growth, raised procalcitonin level. Only ten blood culture-positive patients were CRP positive, and 17 blood culture-positive patients had increased leucocyte counts. When compared with blood culture, sensitivity, specificity, positive predictive value, and negative predictive value of PCT was 100%, 12.31%, 16.18% and 100% respectively. Conclusion: A significant concurrence (p< 0.05), was seen between the elevated serum procalcitonin level and blood culture positive sepsis. Procalcitonin was found to be the better predictor of sepsis when compared to WBC count and CRP (p< 0.05). Elevated procalcitonin level was useful in predicting bloodstream infection and low levels in ruling out an infection.