The value of procalcitonin for diagnosing infection in critically ill patients receiving long-term immunosuppressive therapy / 中华内科杂志

ABSTRACT

Objective To assess the value of procalcitonin(PCT)measurement to differentiate infection from non-infection in critically ill patients requiring long-term immunosuppressive therapy.Methods A prospective study was conducted in patients with underlying diseases requiring corticosteroids or chemotherapy in ICU from January 2008 to December 2009.Patients were divided into the infection group and the non-infection group and their PCT levels were compared.Results A total of 103 patients (65 women)were enrolled in this prospective study[aged(47.9 ± 21.9)years old]with 84 in the infection group and 19 in the non-infection group.The baseline level of PCT was significantly higher in infection than in non-infection patients[2.58(0.08-44.65)pg/L vs 0.62(0.15-6.00)pg/L,P =0.002].Different levels of PCT were manifested in different pathogen groups with 3.41(0.45-44.65)pg/L in bacteria infection,0.99(0.28-6.67)pg/L in fungus infection,0.11(0.08-0.20)pg/L in virus infection group(P =0.018).The AUCROC of PCT was 0.867 for diagnostic bacterial infection.By multivariate analysis,the factors associated with the level of PCT were bacteria infection(OR 5.1,P =0.031)and septic shock(OR 7.5,P =0.027),while the factors not associated with the level of PCT were age,renal function,infection site and prognosis(P ＞ 0.05).Conclusions The level of PCT is increased in the critically ill patients requiring immunosuppressive therapy with infection and it can be used for diagnosis for bacterial infection.