Prospective comparison of eubacterial PCR and measurement of procalcitonin levels with blood culture for diagnosing septicemia in intensive care unit patients

J Clin Microbiol. 2009 Sep;47(9):2964-9. doi: 10.1128/JCM.00418-07. Epub 2009 Jul 29.

Abstract

Rapid identification of infection has a major impact on the clinical course, management, and outcome of critically ill intensive care unit (ICU) patients. We compared the results of PCR and procalcitonin with blood culture for ICU patients suspected of having septicemia. Ninety patients (60 patients meeting the criteria for sepsis and 30 patients not meeting the criteria for sepsis) were evaluated. Compared with blood culture as the gold standard, the sensitivity, specificity, and positive and negative predictive values for PCR were 100%, 43.33%, 46.87%, and 100%, respectively, and for procalcitonin were 100%, 61.66%, 56.6%, and 100%, respectively. The average times required to produce a final result were as follows: PCR, 10 h; blood culture, 33 h; procalcitonin, 45 min. Both PCR and procalcitonin may be useful as rapid tests for detecting septicemia but compared with blood cultures lacked specificity.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteria / isolation & purification*
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • DNA, Bacterial / blood*
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Polymerase Chain Reaction / methods*
  • Predictive Value of Tests
  • Protein Precursors / blood*
  • Sensitivity and Specificity
  • Sepsis / diagnosis*
  • Young Adult

Substances

  • CALCA protein, human
  • DNA, Bacterial
  • Protein Precursors
  • Calcitonin
  • Calcitonin Gene-Related Peptide