Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
J Infect Public Health. 2019 May-Jun;12(3):323-329. doi: 10.1016/j.jiph.2018.11.004. Epub 2018 Nov 26.
Despite the advancement in diagnostic modalities of sepsis, it is still a leading cause of morbidity and mortality. Differentiation between sepsis and non-infectious disease states remains a diagnostic challenge. Procalcitonin (PCT) is useful for the diagnosis of sepsis but it varies in cut-off ranges at different clinical settings. The aim of this study was to correlate serum PCT levels with cultures and to evaluate the best cut-off values with high sensitivity and specificity for PCT.
This prospective study included 305 patients from different medical wards; the patients were classified into group I: controls (n=46), group II: culture-negative sepsis (n=76) and group III: culture-positive sepsis (n=196). Mean p value <0.05 was considered significant.
PCT levels were significantly higher in group II and group III as compared with group I. In group II, the best cut-off point for PCT was 1.3ng/ml with 87.30% sensitivity and 78.26% specificity (area under curve 0.86). In group III, the best cut-off value of 2.20ng/ml with 98.47% sensitivity and 89.13% specificity was found (AUC 0.96).
Procalcitonin can accurately differentiate culture-negative and culture-positive sepsis from non-infectious diseases, thus making it a promising biomarker in diagnosis of bacterial sepsis.
尽管脓毒症的诊断方法有所进步,但它仍然是发病率和死亡率的主要原因。区分脓毒症和非传染性疾病状态仍然是一个诊断挑战。降钙素原 (PCT) 可用于诊断脓毒症,但在不同的临床环境中,其截断值范围不同。本研究的目的是将血清 PCT 水平与培养物相关联,并评估 PCT 的最佳截断值,以实现高灵敏度和特异性。
本前瞻性研究纳入了来自不同内科病房的 305 名患者;患者分为三组:I 组:对照组(n=46)、II 组:培养阴性脓毒症(n=76)和 III 组:培养阳性脓毒症(n=196)。p 值均值<0.05 被认为具有统计学意义。
与 I 组相比,II 组和 III 组的 PCT 水平明显升高。在 II 组中,PCT 的最佳截断点为 1.3ng/ml,灵敏度为 87.30%,特异性为 78.26%(曲线下面积为 0.86)。在 III 组中,发现 2.20ng/ml 的最佳截断值具有 98.47%的灵敏度和 89.13%的特异性(AUC 0.96)。
降钙素原可以准确地区分培养阴性和培养阳性的脓毒症与非传染性疾病,因此成为诊断细菌性脓毒症的有前途的生物标志物。