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Diagnostic Usefulness of Serum Procalcitonin in Patients with Bacterial Sepsis


I.M. Maigari
Y.B. Jibrin
S.A. Gwalabe
J.A. Dunga
A. Abdu
M.S. Umar
H.F. Hassan
A.M. Ballah
M.H. Sulaiman

Abstract

Background: The Sequential Organ Failure Assessment (SOFA) score is used for the diagnosis of sepsis and involves clinical and  laboratory parameters that may not be readily and/or timely available in most resource‑poor settings. Procalcitonin (PCT) has its level  changed in response to bacterial sepsis and its measurement costs only a fraction of the total cost of investigations required to calculate  SOFA score. This study aims to determine the diagnostic usefulness of PCT in bacterial sepsis. 


Materials and Methods: Ninety‑nine  participants were studied, divided into three groups: apparently healthy volunteers, those with bacterial infection without sepsis (SOFA  score <2), and patients with bacterial sepsis (positive culture and SOFA ≥2). PCT level of each participant was measured and median group  levels compared. Pearson’s correlation was used to determine the correlation between serum PCT levels and SOFA scores in the  sepsis group using a significance level of 5 percent (P < 0.05). Diagnostic usefulness of PCT was assessed using receiver operating  characteristic (ROC). 


Result: Positive correlation was found between serum PCT levels and SOFA scores among patients with sepsis r =  0.42, P = 0.016. At a concentration of ≥4.25 ng/ml, serum PCT as a surrogate for SOFA score had a sensitivity and specificity of 57.60% and  84.80%, respectively, for indicating sepsis. The area under the ROC curve (AUC) was 0.74 (95% CI {0.62 to 0.86}, P = 0.001). 


Conclusion:  Serum PCT concentration was significantly higher in bacterial sepsis compared to bacterial infection without sepsis and healthy state. PCT  concentration demonstrated positive correlation with SOFA score in bacterial sepsis and can be used as surrogate for sepsis  screening/ monitoring in resource‑poor settings. 


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eISSN: 2229-7731
print ISSN: 1119-3077