Procalcitonin: A unique marker to evaluate the severity of sepsis among diabetic patients

Authors

  • Mohammad Moniruzzaman Assistant Professor, Department of Immunology, BIRDEM General Hospital, Dhaka - 1000
  • Mousumi Karmaker Assistant Professor, Department of Microbiology, Bangladesh University of Health Sciences, Dhaka – 1216
  • Sadia Tasnim Lecturer, Department of Immunology, Bangladesh University of Health Sciences, Dhaka – 1216
  • Saimun Nahar Rumana Lecturer, Department of Microbiology, Ibrahim Medical College (IMC), Dhaka, Bangladesh
  • Jasmin Nur Research Officer, Department of Immunology, BIRDEM General Hospital, Bangladesh
  • AA Mamun Sarker Research Officer, Department of Immunology, BIRDEM General Hospital, Bangladesh
  • Zeenat F Rahman Senior research Officer, Department of Immunology, BIRDEM General Hospital, Bangladesh
  • Md Sohrab Alam Principal Research Officer and Head, Department of Immunology, BIRDEM General Hospital, Bangladesh
  • Mansura Khan Associate Professor, Department of Immunology, BIRDEM General Hospital, Dhaka - 1000

DOI:

https://doi.org/10.3329/bccj.v10i1.59202

Keywords:

Procalcitonin, High sensitive C-reactive protein, Sepsis.

Abstract

Introduction: Diabetes mellitus (DM) is considered one of the largest emerging threats to health and bacterial infections are more frequent in diabetic patients causing sepsis. Several indicators have been proposed as new diagnostic tests to assess sepsis in hospitalized patients.

Aim: This study aims was to compare the efficacy of Procalcitonin (PCT) and high sensitive C-reactive protein (hs-CRP) in the diagnosis of sepsis in diabetic patients.

Methods: In this cross-sectional study total of 60 age and sex-matched diabetic patients above 18 years were randomly chosen with at least 2 SIRS (Systemic inflammatory response syndrome) criteria from the indoor department of BIRDEM General Hospital. Basic hematological, biochemical, microbiological laboratory data were recorded from laboratory reports. Sepsis and its different stages were determined according to American College of Chest Physicians (ACCP) guidelines. The PCT was measured by sandwich enzyme immunoassay (Bio-Vendor, Germany) and the hs-CRP level was measured using an immune-turbidimetric assay (Beckman, Carlsbad, CA 92010, USA).

Results: The patient’s mean age was 51.90±9.89 years where male 51.2% and female 48.8% and 50-60 years age group was the most common 40%. 38 (63.33%) patients were bacteriological culture-positive and 22 (36.67%) patients were bacteriological culture-negative where the most common organism was Klebsiella (28.95%). Statistically, a significant difference was found in PCT values in the bacteriological culture positive and negative group (p<0.05), but there was no significant difference found in hs-CRP values (p>0.05). There was an increasing trend of serum PCT with the developing stages of sepsis. Receiver operating characteristic curve shows the area under the curve for PCT was 0.785 (95% CI; 0.654-0.915), sensitivity 89.47%, specificity 50%, PPV 75.55% and NPV 73.33% with the best cut-off value >753pg/ml which support PCT as a superior and reliable marker of sepsis.

Conclusion: Our results suggest that serum PCT is a more reliable diagnostic marker of sepsis than other traditional markers like hs-CRP. Combinatorial use of these biomarkers will help in early diagnosis and also greatly improve outcomes.

Bangladesh Crit Care J March 2022; 10 (1): 38-42

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Published

2022-04-25

How to Cite

Moniruzzaman, M. ., Karmaker, M., Tasnim, S. ., Rumana, S. N. ., Nur, J. ., Sarker, A. M., Rahman, Z. F. ., Alam, M. S. ., & Khan, M. . (2022). Procalcitonin: A unique marker to evaluate the severity of sepsis among diabetic patients. Bangladesh Critical Care Journal, 10(1), 38–42. https://doi.org/10.3329/bccj.v10i1.59202

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Original Articles