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| Value of serum procalcitonin, C-reactive protein and white blood cell count in identifying bacterial types of emergency bloodstream infection |
| Liu Yan, Cui Bei-chen, Pi Chun-mei, Wang Cong, Zhao Bin |
| Department of Emergency, Beijing Jishuitan Hospital, Beijing 100035, China |
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Abstract Objective To study the value of serum procalcitonin (PCT), C-reactive protein (CRP) and white blood cell count (WBC) in the identification of emergency bloodstream infection. Methods We retrospectively analyzed the clinical data of 102 patients in the emergency department of Beijing Jishuitan Hospital from January 2017 to December 2017, including the diagnosis of blood flow infection, positive blood culture, and PCT, CRP, blood routine and other biomarkers. The determination results of PCT, CRP and WBC in Gram-negative bacteria group and Gram-positive bacteria group were analyzed statistically, and ROC curve was used to evaluate the differential value of the above biomarkers to different strains. Results Using ROC curve analysis, the sensitivity, specificity, positive predictors and negative predictors of Gram-negative bacteria and Gram-positive bacteria were 53%, 86%, 75.9%and 52.6%, respectively, when the PCT level was 4.28 ng/mL. When CRP level was 96.5 mg/L, the sensitivity, specificity, positive predictors and negative predictors of Gram-negative bacteria and Gram-positive bacteria were 44%, 86%, 88.9% and 39.4%, respectively. The area (AUC) value of the ROC curve of WBC in the identification of Gram-negative bacteria and Gram-positive bacteria was lower than 0.445, and the differential value of the two was less. AUC which combined PCT, CRP and WBC to identification of Gram-negative bacteria and Gram-positive bacteria was 0.770. Conclusion In the bloodstream infection caused by Gram-negative bacteria, the serum PCT level was significantly higher than that caused by Gram-positive bacteria (P<0.05), and the serum PCT level had predictive value for the identification of emergency bloodstream infection caused by Gram-negative bacteria and Gram-positive bacteria. It can provide the references for emergency physicians to choose antibiotics at the early stage of emergency bloodstream infection.
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Corresponding Authors:
Zhao Bin, E-mail: zhaobin60@aliyun.com
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