THE ROLE OF PROCALCITONIN IN BACTERIAL INFECTION RECOGNITION

Background . Early recognition of bacterial infection and antibiotic treatment are very important in critically ill patients. Procalcitonin (PCT) is a marker of bacterial infections accompanied by systemic inflammatory response. Higher values were also noticed with parasitical and fungal infections, but PCT is normal in viral and systemic diseases. The aim of this study was to assess whether PCT is better marker for bacterial infections than C-reactive protein (CRP) and if they have a prognostic value. Methods . 34 patients were included into our retrospective study. All of them had clinical or laboratory signs of infection at the first PCT determination. We measured PCT, CRP, erythrocyte sedimentation rate (SR) and leukocyte count. On the base of microbiological results we divided patients into three groups. Group A had patients with sterile cultures, group B included the ones with negative blood cultures, but from other cultures causative agents were identified. The patients in group C had positive blood cultures. Retrospectively we studied PCT and CRP values among groups and among survivors and non survivors. Results . An average median value of PCT in group A was 8.9 ± 13.3 ng/ml, in group B 5.3 ± 9.3 ng/ml and in group C 21.0 ± 25.0 ng/ml. In group B, the average median value of PCT was significantly higher than in group C (p = 0.019), but that was not the case in group A (p = 0.23). The average median values of CRP were 129.9 ± 67.4 mg/l in group A, 104.3 ± 60.1 mg/l in group B and 117.4 ± 46.1 mg/l in group C. Between groups, differences of CRP values were not statistically significant. The average initial value of PCT in group of non survivors (8.9 ± 49) was not significantly higher then in group of survivors (3.14 ± 55.4) (p = 0.48). The average final value was significantly higher (p = 0.0013) in group of non survivors (13.1 ± 23.9 ng/l) than in group of survivors (0.55 ± 7.3 ng/ml). In both groups the average initial values of CRP did not differ significantly (95.1 ±116.4 mg/l; 144.5 ± 91.4 mg/l; p = 0.26), but the average final value of CRP was significantly higher in the non survivors group (115.5 ± 77.1mg/l; 64.5 ± 48.2 mg/l; p = 0.026).