Clinical value of procalcitonin and hs-CRP in predicting positive blood culture results in sepsis / 国际检验医学杂志

ABSTRACT

Objective To investigate and compare the clinical values of serum procalcitonin (PCT)and high sensitivity C-reac-tive protein (hs-CRP)levels for predicting the blood culture positivity in the patients with sepsis.Methods 132 adult patients with sepsis were enrolled in this study.Blood cultures were performed before the antibacterial therapy.The white blood cell (WBC) count,absolute neutrophil count(ANC),levels of PCT and hs-CRP were determined.The application value of PCT and hs-CRP for predicting the positive blood culture results were evaluated.Results The median serum PCT levels in the blood culture positive group and the blood culture negative group were 7.92 ng/mL and 0.95 ng/mL respectively,the difference had statistical signifi-cance(P <0.01).The receiver operating characteristic (ROC)curves showed that PCT had a higher predictive accuracy for blood culture positivity compared with hs-CRP,the area under the curve (AUC)was 0.810(P =0.001)and 0.690(P =0.274),respec-tively.The combined detection of PCT and hs-CRP for predicting the blood culture positive results was similar to the performance of PCT alone,AUC as 0.885 (P =0.001 ).The median cut point of PCT was 0.91 ng/mL,the sensitivity of PCT for predicting blood culture positivity was 90%.This sensitivity remained unchanged when PCT cut point was1.14ng/mL.Using the PCT cut points of 0.91 and 1.14 enabled reducing the submitted blood cultures by 51% and 56% respectively.Conclusion Compared with hs-CRP,serum PCT level could better predict the blood culture positivity in the patients with sepsis.