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Ability of procalcitonin to differentiate true bacteraemia from contaminated blood cultures in an emergency department.

Abstract：

OBJECTIVES:To analyse and compare the ability of procalcitonin (PCT), C-reactive protein (CRP) and leukocytes to differentiate true bacteraemia from contaminated blood cultures in patients seen in the emergency department (ED) for an episode of infectious disease. METHODS:Observational, retrospective and descriptive analytical study of all blood cultures with positive growth extracted in an ED in adult patients (≥18 years) during 2016 and 2017. The follow-up was carried out over a 30-day period to calculate the predictive power and the prognostic performance for true bacteraemia. RESULTS:A total of 266 blood cultures with positive growth were included in the study. Out of these, 154 (57.9%) were considered true bacteraemia and 112 (42.1%) were considered to be contaminated blood cultures. The area under the Receiver Operating Characteristic curve (AUC-ROC) for PCT to predict true bacteraemia was 0.983 (95% CI: 0.972-0.994; P<0.001) and, considering a cut-off value of≥0.43 ng/ml, PCT achieved 94% sensitivity, 91% specificity, positive predictive value of 94%, and negative predictive value of 92%. The AUC-ROC obtained for CRP was 0.639 (95% CI: 0.572-0.707, P<.001), for leukocytes of 0.693 (95% CI: 0.630-0.756, P<.001) and for immature leukocytes (>10% bands) of 0.614 (95% CI: 0.547-0.682, P<.001). The mean values for PCT were 3.44 (SD 6.30) ng/ml in true bacteraemia vs. 0.16 (SD 0.18) ng/ml in contaminated blood cultures (P<.001). CONCLUSIONS:In blood cultures with positive growth extracted in an ED, PCT achieves the best prognostic performance of true bacteraemia vs. contaminated blood cultures, better than CRP and leukocytes.

journal_name

Enferm Infecc Microbiol Clin

journal_title

Enfermedades infecciosas y microbiologia clinica

authors

Zafar Iqbal-Mirza S,Serrano Romero de Ávila V,Estévez-González R,Rodríguez-González D,Heredero-Gálvez E,Julián-Jiménez A

doi

10.1016/j.eimc.2019.01.012

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

560-568

issue

9

eissn

0213-005X

issn

1578-1852

pii

S0213-005X(19)30129-6

journal_volume

37

pub_type

杂志文章

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