Procalcitonin (ProCT): A Reliable Marker of Sepsis. A Single Centre Experience
Keywords:Procalcitonin, Suspected sepsis, White blood cell, C-reactive protein, Neutropenia
Abstract: Objective: Sepsis occurs in hematological disorders due to neutropenia, clinical signs and symptoms are not specific for its diagnosis. Early biomarkers are potentially helpful for the diagnosis in these patients. This study was done to assess the utility of Procalcitonin (ProCT) as a marker of sepsis in patients with hematological disorders.
Methods: A cross sectional study was conducted in the section of clinical chemistry, department of laboratory, National institute of Blood disease and Bone marrow transplantation (NIBD) Hospital in Karachi Pakistan. Total 366 patients with age groups of 15 to 60 years with suspected sepsis undergone ProCT test were enrolled in the study, their blood cultures results and biomarkers including; White blood cell (WBC) count, C-reactive protein (CRP) and Absolute Neutrophil count (ANC) were also recorded. Sepsis was labeled as per surviving sepsis campaign (SSG) international guidelines for management of severe sepsis and Septic Shock 2012 criteria. Results: Biomarkers of culture positive patients were compared with culture negative patients. The statistically significant difference was noted in ProCT (p value < 0.001) and CRP (p value < 0.003). However, no significant differences were noted in WBC count (p value > 0.05) and ANC count (p value > 0.05). ProCT had outstanding diagnostic accuracy with area under receiver operator characteristic curve (AUC) was 0.95 ; ( 95%CI0.89 - 1.00), that for CRP was modest (AUC 0.74; 95%CI 0.61-0.87), while that for WBC and ANC were poor with AUC 0.43; (95%CI0.311-0.58), AUC 0.44(95%CI 0.28-0.54) respectively.
Conclusion: ProCT alone showed the excellent diagnostic power on ROC analysis which proves it as a stronger diagnostic biomarker for sepsis in hematological disorders.