Roles of C-Reactive Protein and Procalcitonin in Empirical Treatment Approach to the Bacterial Sepsis Agent

Abstract

Objective: The primary aim of our study was to investigate the usefulness of serum C-reactive protein (CRP) and procalcitonin (PCT) levels in the differential diagnosis of causative gram-positive (Gram+) or gram-negative (Gram-) bacteria in patients with sepsis to facilitate decisions concerning the initial choice of an empiric antibiotic regimen.Methods: Between February 2014 and February 2016, 47 patients who had sepsis diagnosed on the basis of positive blood cultures and clinical examination results were retrospectively enrolled. Serum CRP and PCT levels of 15 gram+ and 32 gram- bacterial sepsis groups were compared using the Mann–Whitney U test. The correlation between CRP and PCT levels was calculated using the Spearman’s test.Results: Among patients with bacterial sepsis, the median CRP level was 91.42 mg/L and the median PCT level was 0.46 ng/mL. There were no significant difference in CRP and PCT levels between the gram+ and gram- sepsis groups (p=0.98 and p=0.21, respectively). There was good correlation between the CRP and PCT levels (r=0.64, p<0.001).Conclusion: Considering the changes and the status of proinflammatory/ anti-inflammatory responses in the pathogenesis of sepsis, we believe that CRP and PCT levels alone are insufficient for predicting the type of causative bacteria in sepsis.

Keywords

• Procalcitonin
• C-reactive protein
• sepsis
• gram-positive bacteria
• gram-negative bacteria