Prospective Comparison of Eubacterial PCR and Measurement of Procalcitonin Levels with Blood Culture for Diagnosing Septicemia in Intensive Care Unit Patients

Abstract

Rapid identification of infection has a major impact on the clinical course, management, and outcome of critically ill intensive care unit (ICU) patients. We compared the results of PCR and procalcitonin with blood culture for ICU patients suspected of having septicemia. Ninety patients (60 patients meeting the criteria for sepsis and 30 patients not meeting the criteria for sepsis) were evaluated. Compared with blood culture as the gold standard, the sensitivity, specificity, and positive and negative predictive values for PCR were 100%, 43.33%, 46.87%, and 100%, respectively, and for procalcitonin were 100%, 61.66%, 56.6%, and 100%, respectively. The average times required to produce a final result were as follows: PCR, 10 h; blood culture, 33 h; procalcitonin, 45 min. Both PCR and procalcitonin may be useful as rapid tests for detecting septicemia but compared with blood cultures lacked specificity.

Utility Of Procalcitonin As A Diagnostic And Prognostic Biomarker Of Sepsis In Comparison To Culture & Other Inflammatory Markers

“…30,32 In contrast to this, majority of studies have reported that procalcitonin was a better marker to estimate the severity, prognosis, or further course of the sepsis. 33,36 This study was consistent to the others with a few minor limitations. First, serial PCT monitoring every day was avoided which may improve its performance as an aid for follow up of sepsis.…”

Multiplex Blood PCR in Combination with Blood Cultures for Improvement of Microbiological Documentation of Infection in Febrile Neutropenia

“…Homemade multiplex or broad-range PCR assays for the detection of bloodstream pathogens in cases of sepsis or febrile neutropenia have provided variable sensitivity and specificity compared with blood cultures (5,8,9,28,31,42,44). Their use is limited by the lack of standardized technical procedures and commercially available systems.…”

Clinical Evaluation of Multiple Inflammation Biomarkers for Diagnosis and Prognosis for Patients with Systemic Inflammatory Response Syndrome

“…Early and reliable diagnosis for appropriate treatment is essential for improving the prognosis of infected patients. While so far, no single biomarker was able to replace time-consuming blood cultures, some, like procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6), are commonly used for additional assessments (2,3).…”