Study on the application value of leukocyte,procalcitonin and C-reactive protein in early diagnosis of bloodstream infection / 国际检验医学杂志

ABSTRACT

Objective To explore the clinical significances of leukocyte (WBC ) ,C‐reactive protein (CRP ) and procalcitonin (PCT) in early diagnosis of bacterial bloodstream infections (BSI) ,in order to provide references for early diagnosis of BSI . Methods The detection results of WBC ,PCT and CRP from 48 cases of patients with positive blood culture(positive blood culture group) and 50 cases of patients with negative blood culture(negative blood culture group) were retrospectively analysed .Then com‐pared the detection results between the two groups ,and between patients with gram‐positive bacteria infection and those with gram‐negative bacteria infection in the positive blood culture group .The diagnostic performance of WBC ,PCT and CRP were determined by drawing the receiver operator characteristic(ROC) curves ,and areas under ROC curves(ACUs) were calculated .The perform‐ance of the three indicators in predicting BSI were evaluated by using the binary logistic regression analysis .Results The levels of PCT and CRP in positive blood culture group was significantly higher than those in negative blood culture group ,had statistically significant differences(P0 .05) .In the positive blood culture group ,statistically significant difference was only found in PCT level between patients with gram‐positive bacteria infection and patients with gram‐negative bacteria infection(P<0 .05) .The AUCs of WBC ,PCT and CRP were 0 .579 ,0 .746 and 0 .624 ,respectively .The result of the binary logistic regression analysis showed that only PCT made a unique statistically significant contribution to the model(P=0 .013) for predictive diagnosis of BSI .And the positive predictive rate of joint detection of these three indicators was 71 .4% .Conclusion WBC ,PCT and CRP could be indicators for early diagnosis of BSI ,while PCT and CRP might have much more important significance ,moreover ,PCT could distinguish between gram‐positive bacterial in‐fection and gram‐negative bacteria infection .