Prokalsitonin, CRP Dan Presepsin Serum Di Sirs

Abstract

Infection in ICU patients can lead to a septic condition with clinical signs similar to Systemic Inflammatory Response Syndrome (SIRS). The high risk of death and high cost of sepsis is the reason to find an early marker in diagnosing sepsis. Blood culture can givea result in 1-3 days, so C reactive protein, procalcitonin and presepsin which are fast and accurate are needed to find a septic condition in SIRS patients. The aim of this study is to determine the diagnostic value of CRP, PCT and presepsin of sepsis with blood culture as the gold standard., The samples were collected from 32 clinically SIRS patients in the Dr. Kariadi Hosiptal, Semarang. The PCT level was measured using ELFA method, CRP level by PET IA method, while presepsin level by CLEA method. The determined area was under curve (AUC) and the cut off level was determined by 2×2 table to find out the sensitivity, spesificity, positive predictive value, negative predictive value and likelihood ratio of CRP, PCT and presepsin as well. The AUC of PCT, CRP and presepsin was 0.78 (cut off 4.314 ng/mL); 0.673 (cut off 10.245 mg/L) and 0.814 (cut off 1134.5 pg/mL). The presepsin level had a higher sensitivity (90%) than PCT (80%) and CRP (70%). PCT specificity was 72.73%, presepsin and CRP specificity each was 68.18%. Based on this study, AUC and sensitivity of presepsin level were found higher than the PCT and CRP level.

Procalcitonin as a Marker of Sepsis Due to Bacterial Infection

“…This PCT cut-off value of 0.8 ng/ml supports the theory that serum PCT levels of 0.5 -2.0 ng/ml are usually found in local infections, and PCT levels > 2 ng/ml represent sepsis or uncontrolled systemic bacterial infection. [24]. This increase in PCT levels occurs due to stimulation by bacterial endotoxins or the body's inflammatory cell response to increasing PCT secretion [21].…”

“…A serum PCT level of 0.5 -2.0 ng/ml is indicated by abnormal conditions or local infection and requires a supportive diagnosis of sepsis. Meanwhile, levels > 2 ng/ml were found in patients with sepsis or uncontrolled systemic bacterial infection [24]. Measurement of PCT levels can be used to diagnose and monitor the course of the disease and follow-up therapy in severe bacterial infections and sepsis [7,19].…”

Diagnostic Value of Mid Regional Proadrenomedullin as a Sepsis Biomarker in Pediatric Patients with Cancer-Related Chemotherapy

“…Therefore, many criteria and diagnosis guidelines has been established for diagnosis of sepsis, which included clinical sign, symptoms, with addition of several laboratory parameters 5 . However, many biomarkers have been used by clinician to diagnose sepsis in their daily practice, e.g., C-reactive protein, procalcitonin and presepsin 6 . Their results were useful to decide giving empirical antibiotics 7 .…”