Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 22 , ISSUE 2 ( 2018 ) > List of Articles


Diagnostic Value of Procalcitonin in Predicting Bacteremia in Intensive Care Unit

Tuna Demirdal, Pinar Sen, Salih Atakan Nemli

Keywords : Bacteremia, Internal Care Unit, procalcitonin, sepsis

Citation Information : Demirdal T, Sen P, Nemli SA. Diagnostic Value of Procalcitonin in Predicting Bacteremia in Intensive Care Unit. Indian J Crit Care Med 2018; 22 (2):78-84.

DOI: 10.4103/ijccm.IJCCM_437_17

License: CC BY-ND 3.0

Published Online: 01-12-2014

Copyright Statement:  Copyright © 2018; The Author(s).


Background and Aims: Several biomarkers are used in the diagnosis of bacteremia. Procalcitonin (PCT) is more specific than other biomarkers in differentiating bacterial and nonbacterial inflammation. It was aimed to evaluate the diagnostic and prognostic value of PCT in bacteremic patients in Intensive Care Unit (ICU). Materials and Methods: A total of 156 patients diagnosed with noninfectious systemic inflammatory response syndrome, sepsis, and severe sepsis/septic shock in ICU between December 2014 and July 2015 were evaluated in this prospective cohort study. Results: The study group consisted of 64 (41%) bacteremic patients and the control group consisted of 92 (59%) nonbacteremic patients. The overall mortality rate was 60.3%. Although PCT levels in the bacteremic group (11.9 ± 21.5 ng/dL) were higher than nonbacteremic group (5.9 ± 11.5 ng/dL), this difference was not significant (P = 0.168). The mean levels of PCT in bacteremic patients with Gram-negative bacteria were 16.3 ± 27.6 ng/dL, whereas Gram-positive bacteria were 7.3 ± 10.7 ng/dL (P = 0.145). The mean PCT levels were significantly higher in nonsurvivors compared to survivors (10.1 ± 18.0 vs. 5.7 ± 13.7 ng/dL; P < 0.001). Conclusions: PCT may be an effective biomarker for diagnosing sepsis and predicting disease severity and mortality. There is a need for further well-designed studies to confirm the diagnostic and prognostic value of PCT in septic patients in critical care.

PDF Share
  1. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013;39:165-228.
  2. Prucha M, Bellingan G, Zazula R. Sepsis biomarkers. Clin Chim Acta 2015;440:97-103.
  3. Vazquez-Grande G, Kumar A. Optimizing antimicrobial therapy of sepsis and septic shock: Focus on antibiotic combination therapy. Semin Respir Crit Care Med 2015;36:154-66.
  4. Chivate CG, Belwalkar GJ, Limaye RP, Patil RV. Procalcitonin as a marker for the diagnosis of sepsis. Int J Res Med Sci 2016;4:1216-8.
  5. Wacker C, Prkno A, Brunkhorst FM, Schlattmann P. Procalcitonin as a diagnostic marker for sepsis: A systematic review and meta-analysis. Lancet Infect Dis 2013;13:426-35.
  6. Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: A systematic review and meta-analysis. Clin Infect Dis 2004;39:206-17.
  7. Cho SY, Choi JH. Biomarkers of sepsis. Infect Chemother 2014;46:1-2.
  8. Liu D, Su L, Han G, Yan P, Xie L. Prognostic value of procalcitonin in adult patients with sepsis: A Systematic review and meta-analysis. PLoS One 2015;10:e0129450.
  9. Li S, Rong H, Guo Q, Chen Y, Zhang G, Yang J, et al. Serum procalcitonin levels distinguish gram-negative bacterial sepsis from gram-positive bacterial and fungal sepsis. J Res Med Sci 2016;21:39.
  10. European Committee on Antimicrobial Susceptibility Testing. Version 7.0; 2014.
  11. Yap CY, Aw TC. The use of procalcitonin in clinical practice. Proc Singapore Healthc 2014;23:33-7.
  12. Anderson DJ, Moehring RW, Sloane R, Schmader KE, Weber DJ, Fowler VG Jr., et al. Bloodstream infections in community hospitals in the 21st century: A multicenter cohort study. PLoS One 2014;9:e91713.
  13. Süner A, Karaoğlan I, Mete AO, Namiduru M, Boşnak V, Baydar I, et al. Assessment of bloodstream infections and risk factors in an İntensive Care Unit. Turk J Med Sci 2015;45:1243-50.
  14. Koupetori M, Retsas T, Antonakos N, Vlachogiannis G, Perdios I, Nathanail C, et al. Bloodstream infections and sepsis in Greece: Over-time change of epidemiology and impact of de-escalation on final outcome. BMC Infect Dis 2014;14:272.
  15. Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med 2013;369:840-51.
  16. Lagu T, Rothberg MB, Shieh MS, Pekow PS, Steingrub JS, Lindenauer PK, et al. Hospitalizations, costs, and outcomes of severe sepsis in the United States 2003 to 2007. Crit Care Med 2012;40:754-61.
  17. Leli C, Ferranti M, Moretti A, Al Dhahab ZS, Cenci E, Mencacci A, et al. Procalcitonin levels in gram-positive, gram-negative, and fungal bloodstream infections. Dis Markers 2015;2015:701480.
  18. Su L, Feng L, Song Q, Kang H, Zhang X, Liang Z, et al. Diagnostic value of dynamics serum sCD163, sTREM-1, PCT, and CRP in differentiating sepsis, severity assessment, and prognostic prediction. Mediators Inflamm 2013;2013:969875.
  19. Qu J, L X, Liu Y, Wang X. Evaluation of procalcitonin, C-reactive protein, interleukin-6 & serum amyloid A as diagnostic biomarkers of bacterial infection in febrile patients. Indian J Med Res 2015;141:315-21.
  20. Watkins RR, Lemonovich TL. Serum procalcitonin in the diagnosis and management of intra-abdominal infections. Expert Rev Anti Infect Ther 2012;10:197-205.
  21. Brooks D, Smith A, Young D, Fulton R, Booth MG. Mortality in intensive care: The impact of bacteremia and the utility of systemic inflammatory response syndrome. Am J Infect Control 2016;44:1291-5.
  22. Rejeb MB, Sahli J, Chebil D, Khefacha-Aissa S, Jaidane N, Kacem B, et al. Mortality among patients with nosocomial infections in tertiary Intensive Care Units of Sahloul hospital, Sousse, Tunisia. Arch Iran Med 2016;19:179-85.
  23. Fialkow L, Farenzena M, Wawrzeniak IC, Brauner JS, Vieira SR, Vigo A, et al. Mechanical ventilation in patients in the Intensive Care Unit of a general university hospital in Southern Brazil: An epidemiological study. Clinics (Sao Paulo) 2016;71:144-51.
  24. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 2016;315:801-10.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.