Evaluation of Procalcitonin (PCT) and C-reactive protein (CRP) as biomarkers in suspected cases of sepsis among patients attending Emergency Department and ICU of the tertiary care hospital in Western Uttar Pradesh

Abstract

Background: Procalcitonin has characteristics of a biomarker, as there is a fast and specific increase in sepsis and it differentiates infections from non-infectious causes of sepsis. The present study was conducted to evaluate procalcitonin (PCT) and C-reactive protein (CRP) as biomarkers in suspected cases of sepsis. Materials & Methods: The study was conducted on 80 cases in the department of medicine at Uttar Pradesh University of Medical Sciences (UPUMS), Saifai, Etawah. Cases clinically suspected of sepsis on admission to emergency department were included. 5ml of venous blood sample was withdrawn simultaneously for detection of PCT and CRP. Results: There were 45 (56.2%) male and 35 (43.7%) female. Blood culture was positive in 26 (32.5%) and negative in 54 (67.5%). Among 26 positive blood culture cases, 5 (19.23%) were caused by Gram-positive bacteria and 21 (80.76%) by Gram-negative bacteria. In Gram-positive cultures all 5 isolates identified were of Staphylococcus aureus. In Gram-negative cultures most common isolates were E. coli 9 (34.61%), followed by Klebsiella pneumoniae 6 isolates (23.07%) and 6 isolates of non-fermenting gram-negative bacilli (NFGNB) were isolated. Clinical conditions present in study subjects were chronic lung disease in 31cases (38.7%) followed by acute kidney failure in 27 cases and anaemia in 24 cases. Three cases also had gastrointestinal disease. Source of infection in culture positive patients were pneumonia 9 cases (34.6%), UTI 8 cases (30.7%), skin wounds/cellulitis 4 cases (15.3%), meningitis and biliary tract infection 3 cases each (11.5%). Source of infection in culture negative cases was pneumonia 19 cases (35.1%) followedbyUTI11cases (20.3%). Conclusion: PCT proved to be a reliable marker for sepsis diagnosis and is more relevant than CRP in patients with a positive blood culture.