Procalcitonin and fever as markers of bacteraemia in patients with sepsis

Abstract number: 1135_170

Lupse M., Slavcovici A., Ursu L., Flonta M., Bondor C., Tatulescu D.

Objective:  

To assess the clinical informative value of Procalcitonin (PCT) plasma concentration and fever as markers of bacteraemia in patients with sepsis.

Material and methods:  

All adult patients admitted between Jan 2002 and Aug 2004 who fulfilled the criteria for sepsis/severe sepsis according to the American College of Chest Physicians/Society of Critical Care Medicine. Fever and plasma PCT with a semi-quantitative method were measured and two sets of blood cultures were taken at admittance. Patients without proven bacterial sepsis were excluded. We compared results in patients with or without bacteraemia using t test, chi-square test and descriptive statistics.

Results:  

117 patients with bacterial sepsis/severe sepsis were included, 73 (62%) with bacteraemia: 24 with Gram-positive bacteraemia and 49 with Gram-negative bacteraemia. There were no statistically significant differences between either bacteremic and nonbacteremic (p = 0.46) or between Gram-negative and Gram-positive (p = 0.37) bacteremic patients, regarding fever. At cut-off value of 2 ng/ml, PCT discriminate between bacteremic and non-bacteremic septic patients (p = 0.0002) with a positive predictive value of 80% and a sensitivity of 78% for bacteraemia. There are no significant differences for PCT values between Gram positive and Gram-negative bacteremic patients but at cut-off of 10 ng/ml for PCT the positive predictive value was 73% for Gram-negative bacteraemia.

Conclusion:  

Fever does not have a discriminatory power for bacteraemia in septic patients and the use of PCT assessment could help physicians limit the number of blood cultures to be processed.