Diagnostic value of combined detection of inflammatory indicators in bloodstream infection with different pathogenic bacteria

Abstract:

ObjectiveTo investigate the diagnostic value of combined detection of procalcitonin (PCT), Creactive protein (CRP), white blood cell (WBC), and neutrophil percentage (NEU%) in bloodstream infection with grampositive coccus(G+), gramnegative bacillus (G- ）and fungus. MethodsDetection results of positive blood culture of 389 patients in a hospital between January 2014 and December 2015 were analyzed retrospectively, according to the results of blood culture, patients were divided into G+ coccus, G- bacillus and fungal bloodstream infection groups, inflammatory indicators of different groups of patients were compared. ResultsMannWhitney U test revealed that PCT level of G- infection group was higher than that of G+ and fungal infection group (comparison between G- infection group and G+ infection group : Z=-2.68，P＜0.01；comparison between G- infection group and fungal infection group: Z=-2.46，P＜0.05）. If PCT≥0.5 ng/mL, CRP≥5.0 mg/L, NEU%≥70% and WBC≥10×109/L were as the cutoff point, statistical analysis revealed the positive rate of PCT in G- infection group was higher than that in G+ and fungal infection group(comparison between G- infection group and G+ infection group：χ2=5.94，P＜0.05；comparison between G- infection group and fungal infection group：χ2=7.721，P＜0.01）；the positive rate of CRP in G- infection group was higher than that in G+ infection group (χ2=5.03，P＜0.05）. Binary logistic regression was adopted to analyze the efficacy of four indicators for the differentiation of bloodstream infection caused by G+ coccus,   G- bacillus, and fungus, only PCT had significant difference in the identification of bloodstream infection caused by G- bacillus, G+ coccus and fungus(P<0.01). ConclusionPCT has high accuracy in differentiating G- bacillus, G+ coccus, and fungus of blood culture, dynamic monitoring of PCT combined with detection results of CRP, WBC, and NEU%, patient’s condition can be judged rapidly, and antimicrobial agents can be used rationally, so the mortality of patients with bloodstream infection can be reduced.