Abstract

In spite of the advances in critical care medicine, early diagnosis and proper treatment of bacterial sepsis is a challenge in intensive care unit. Procalcitonin (PCT) an innovative and better laboratory marker, has been recently proven to be appropriate and efficient in treating bacterial sepsis. Aim: To determine the diagnostic accuracy of Procalcitonin (PCT), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) as individual and combined indicators of bacterial sepsis and compare ESR, CRP, PCT to the gold standard microbiological cultures. Materials and Methods: This study was a retrospective study which was conducted during the period of 1 year which was between August 2022 to August 2023. This study was conducted in General surgery department, SVIMS-SPMC(W), Tirupati in a total of 80 patients. Results: Majority of patients were in the age group of 51-60 years which constituted 21 patients (26.2%). Majority of patients were males which constituted 66 (82.5%). Females were 14 (17.5%). C-reactive protein was in between 100-150 mg/dl in 16 patients (20%) at admission and after 48 hrs, less than 10 mg/dl C-reactive protein was observed in 6 patients which is considered abnormal. procalcitonin (ng/mL) was greater than 0.25 ng/mL in 69 patients (86.3%) at admission which indicates the presence of infection. After 48 hours, infection was reduced in 54 patients (67.5%). At admission active infection was observed in 27 patients (33.8%) at admission with ESR >100 mm/hr and it was reduced to 8, 10% after 48 hours. 9 positive blood cultures and 3 negative blood cultures were observed in patients with less than 2 ng/mL procalcitonin, 4 positive blood cultures and 3 negative blood cultures were observed in patients with 2-10 ng/mL procalcitonin, 8 positive blood cultures and 1 negative blood cultures were observed in patients with more than 10 ng/mL procalcitonin. Conclusion: PCT was more efficient diagnostic tool when compared to CRP and ESR in detecting severity of infection.

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