Oksuz Lutfiye, Somer Ayper, Salman Nuran, Erk Osman, Gurler Nezahat
Istanbul Faculty of Medicine Department of Medical Microbiology Istanbul Turkey Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey.
Istanbul Faculty of Medicine Department of Pediatric Infectious Diseases Istanbul Turkey Istanbul Faculty of Medicine, Department of Pediatric Infectious Diseases, Istanbul, Turkey.
Braz J Microbiol. 2015 Mar 4;45(4):1415-21. doi: 10.1590/s1517-83822014000400036. eCollection 2014.
Procalcitonin (PCT) and C-reactive protein (CRP) are important biological markers used in the diagnosis of severe infections. The aim of this study was to evaluate the consistency of blood culture with PCT and CRP in differentiating contamination and non-bacteremia from true bacteremia. In this study blood samples were obtained from 809 febrile patients and analyzed using BACTEC 9120 system. All of positive blood cultures were performed Gram staining. The microorganisms were identified with conventional methods and automated systems. Antibiotic susceptibility tests were made by disc diffusion. PCT levels were analyzed by mini VIDAS device and PCT kit. PCT and CRP levels were analyzed with blood cultures in same times. Kruskal Wallis test, Mann-Whitney U test, Spearman's rho test and ROC curve were used for statistical analyses. The bacteremia group was found to be significantly different from non-bacteremia group and contamination group in terms of both PCT and CRP (p<0.0001). The p values of PCT and CRP in differentiating bacteremia from non-bacteremia were p<0.001 for PCT, p=0.002 for CRP and in differentiating bacteremia from contamination were p<0.001 for PCT, p<0.001 for CRP. PCT is a more useful marker than CRP in the differentiating of true bacteremia from contamination according to the results of this study.
降钙素原(PCT)和C反应蛋白(CRP)是用于诊断严重感染的重要生物标志物。本研究的目的是评估血培养与PCT和CRP在区分污染、非菌血症与真正菌血症方面的一致性。在本研究中,从809例发热患者采集血样,并使用BACTEC 9120系统进行分析。所有阳性血培养均进行革兰氏染色。采用传统方法和自动化系统鉴定微生物。通过纸片扩散法进行药敏试验。使用mini VIDAS设备和PCT试剂盒分析PCT水平。同时分析血培养中的PCT和CRP水平。采用Kruskal Wallis检验、Mann-Whitney U检验、Spearman秩相关检验和ROC曲线进行统计分析。菌血症组在PCT和CRP方面均与非菌血症组和污染组有显著差异(p<0.0001)。PCT和CRP在区分菌血症与非菌血症时,PCT的p值<0.001,CRP的p值=0.002;在区分菌血症与污染时,PCT的p值<0.001,CRP的p值<0.001。根据本研究结果,在区分真正菌血症与污染方面,PCT是比CRP更有用的标志物。