Measuring both procalcitonin and C-reactive protein for a diagnosis of sepsis in critically ill patients

Abstract

Background: The usefulness of procalcitonin (PCT) and C-reactive protein (CRP) as individual biomarkers, and in combination, for the identification of infections in a critically ill patient cohort was evaluated retrospectively. Methods: Best cut-off values for PCT and CRP for a diagnosis of sepsis in critically ill patients were determined using receiver operator characteristic (ROC) curve analysis. Both combined tests and individual tests were performed for PCT and CRP, with positive and negative results recorded, and accuracy evaluated using odds ratios (OR). Results: In the 55 critically ill patients studied, the best cut-off value for PCT for a diagnosis of sepsis was 1.1 ng/ml (sensitivity, specificity and negative predictive values [NPV] were 82%, 68% and 71%, respectively). In addition, the best cut-off value for CRP was 50.7 mg/l ( sensitivity, specificity and NPV of 90%, 68% and 83%, respectively). Measuring PCT and CRP in combination provided a sensitivity of 79%, a specificity of 86%, and a positive predictive value (PPV) of 90%. Diagnostic OR for the combination of biomarkers versus CRP alone (19 and 18, respectively) were greater than that for PCT (9). Conclusion: For critically ill patients, CRP and CRP in combination with PCT were found to be suitable biomarkers for diagnosing sepsis, based on their NPV and PPV.

Correlation of Neutrophils/Lymphoctes Ratio and C-Reactive Protein in Sepsis Patients

“…Therefore, the levels of CRP were in accordance with the severity of organ function. The same results were also reported in a research conducted by Hong-Xiang et al 16 Table 3 showed that the largest group (40.5%) was the samples of sepsis patients with RNL above 5 and CRP levels between 100-200. This indicated that sepsis in this research was most often caused by a bacterial infection.…”

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

“…There is a notable increase of CRP level 4-6 h after stimulation. These levels double every 8 h and peak 36 to 50 h after an infection/inflammation stimulus [14] . CRP measurement is cheap and rapidly available, but increases of CRP levels are unspecific, since they can be observed, i.e., after surgery or trauma [15] .…”

Validity of biomarkers in screening for neonatal sepsis – A single center –hospital based study

“…2 C-reactive protein (CRP) is generally considered a helpful marker for diagnosis of sepsis used in addition to blood culture, but sometimes it may be inadequate for sepsis diagnosis, so more rapid efficient markers are needed. 3 CRP is an acute phase protein synthesized in liver in the presence of infectious and/or inflammatory stimuli, correlating with the disease severity, 4 but its production significantly varied during the neonatal period, 5 with lower production in preterm compared to full term neonates. 6 The high sensitivity assays of CRP (hsCRP) could detect lower grade of inflammation.…”