Early Prediction of Bacterial Infection with Procalcitonin at Different Stages of Sepsis

Introduction: The time factor and inconclusive results of microbiological data in early sepsis mandate searching for a biomarker which could posses early culture predictive power. Aim of the Work: To investigate whether procalcitonin (PCT) and C-reactive protein (CRP) could confer early alarm in sepsis related bacterial infection. Patients and Method: One hundred and forty patients (77 males and 63 females) with a mean age of 55.6±19 years were enrolled in our study. All were subjected to serial measuring of CRP and PCT, and sequential organ failure assessment (SOFA) scores daily for 7 days (day 1 starting symptoms). Blood samples and appropriate cultures were collected before starting antibiotics. The acute physiology and chronic health evaluation (APACHE) II score was used to determine the initial severity of illness. Patients were divided into 2 groups: Group A: Culture positive, and Group B: Culture negative. PCT and CRP level related to early prediction of culture results of each group. Results: Underlying clinical diagnosis revealed respiratory tract infection in 48 patients, urinary tract infection in 9, bloodstream infection in 10, and other infections in 10, while infection could not be traced in 63 patients. Our data demonstrated the ability of PCT to predict culture positivity through changes in PCT from day 1 and day 3 (PCT3 - PCT1), meanwhile CRP failed to reproduce the same data. Conclusions: Procalcitonin may serve as better biomarker for early correlation with culture results.