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The aim of this retrospective study is to determine the predictive role of serum level of procalcitonin (PCT) and c-reactive protein (CRP) in determining the causative agent of sepsis in surgical intensive care unit (ICU) patients. The main question it aims to answer is: what serum level of PCT and CRP is predictive of gram+ and gram- sepsis in patients with positive blood cultures in the surgical ICU. The study will be retrospective and will include all patients with positive blood cultures who were hospitalized in the surgical ICU of University Hospital Osijek in the period from January 2019 to May 2022.
PCT is a good biochemical marker of severe bacterial infection. Numerous studies have confirmed its role in the diagnosis of sepsis, especially sepsis with positive blood cultures. This retrospective study will include septic patients who were hospitalised in the surgical ICU between January 2019 and May 2022, and who had at least one positive blood culture. The values of PCT, CRP, white blood cells count and platelets count, as well as the overall outcome of the treatment, will be recorded for the patients included in the research. The aim of the research is to examine the differences in the level of PCT, CRP, white blood cells count and platelets count between patients with gram+ and gram- blood cultures. Also, the predictive value of PCT and CRP in differentiating gram+ from gram- hem will be examined.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Gram negative | Patients who had at least one blood culture with a gram- isolate during hospitalisation in the surgical ICU |
| |
| Gram positive | Patients who had at least one blood culture with a gram+ isolate during hospitalisation in the surgical ICU |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PCT levels | Diagnostic Test | All patients will have their serum PCT level recorded on the day of the positive blood culture and in the next three days. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Predictive level of PCT | Predictive serum level of PCT in differentiating gram+ from gram- blood culture | 4 days |
| Predictive level of CRP | Predictive serum level of CRP in differentiating gram+ from gram- blood culture | 4 days |
| Measure | Description | Time Frame |
|---|---|---|
| White blood cells count | Test for differences in WBC count between patients with gram+ and gram- blood cultures | 4 days |
| Platelets count | Test for differences in platelets count between patients with gram+ and gram- blood cultures |
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Inclusion Criteria:
Exclusion Criteria:
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Patients older than 18 years who were hospitalized in the surgical ICU between January 2019 and May 2022 and who had at least one positive blood culture during treatment will be included in the research.
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| Name | Affiliation | Role |
|---|---|---|
| Nenad Neskovic, PhD | Principal Investigator | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Osijek | Osijek | 31000 | Croatia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 12071576 | Background | Morgenthaler NG, Struck J, Fischer-Schulz C, Seidel-Mueller E, Beier W, Bergmann A. Detection of procalcitonin (PCT) in healthy controls and patients with local infection by a sensitive ILMA. Clin Lab. 2002;48(5-6):263-70. | |
| 8094770 | Background | Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohuon C. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet. 1993 Feb 27;341(8844):515-8. doi: 10.1016/0140-6736(93)90277-n. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Sep 4, 2024 | |
| Reset | Nov 14, 2024 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Sep 4, 2024 | Nov 14, 2024 |
| ID | Term |
|---|---|
| D018805 | Sepsis |
| ID | Term |
|---|---|
| D007239 | Infections |
| D018746 | Systemic Inflammatory Response Syndrome |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
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| ID | Term |
|---|---|
| D007958 | Leukocyte Count |
| D010976 | Platelet Count |
| ID | Term |
|---|---|
| D001772 | Blood Cell Count |
| D002452 | Cell Count |
| D003584 | Cytological Techniques |
| D019411 | Clinical Laboratory Techniques |
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The values of PCT, CRP, white blood cells and platelets will be recorded retrospectively for all patients included in the study
| CRP levels | Diagnostic Test | All patients will have their serum CRP level recorded on the day of the positive blood culture and in the next three days. |
|
| White blood cell count | Diagnostic Test | All patients will have their white blood cell (WBC) count recorded on the day of the positive blood culture and in the next three days. |
|
| Platelet count | Diagnostic Test | All patients will have their platelets count recorded on the day of the positive blood culture and in the next three days. |
|
| 4 days |
| PCT levels and outcome | To examine differences in serum PCT levels between patients who survived and those who died | 4 days |
| CRP levels and outcome | To examine differences in serum CRP levels between patients who survived and those who died | 4 days |
| 21808399 | Background | Sinha M, Desai S, Mantri S, Kulkarni A. Procalcitonin as an adjunctive biomarker in sepsis. Indian J Anaesth. 2011 May;55(3):266-70. doi: 10.4103/0019-5049.82676. |
| 25726038 | Background | Hoeboer SH, van der Geest PJ, Nieboer D, Groeneveld AB. The diagnostic accuracy of procalcitonin for bacteraemia: a systematic review and meta-analysis. Clin Microbiol Infect. 2015 May;21(5):474-81. doi: 10.1016/j.cmi.2014.12.026. Epub 2015 Jan 14. |
| 30497960 | Background | Gupta S, Jaswani P, Sharma RK, Agrawal S, Prasad N, Sahu C, Gupta A, Prasad KN. Procalcitonin as a diagnostic biomarker of sepsis: A tertiary care centre experience. J Infect Public Health. 2019 May-Jun;12(3):323-329. doi: 10.1016/j.jiph.2018.11.004. Epub 2018 Nov 26. |
| 34675564 | Background | Yang L, Lin Y, Wang J, Song J, Wei B, Zhang X, Yang J, Liu B. Comparison of Clinical Characteristics and Outcomes Between Positive and Negative Blood Culture Septic Patients: A Retrospective Cohort Study. Infect Drug Resist. 2021 Oct 12;14:4191-4205. doi: 10.2147/IDR.S334161. eCollection 2021. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D019937 |
| Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D006403 | Hematologic Tests |
| D008919 | Investigative Techniques |
| D002468 | Cell Physiological Phenomena |
| D001790 | Blood Physiological Phenomena |
| D002943 | Circulatory and Respiratory Physiological Phenomena |
| D010979 | Platelet Function Tests |