title: Procalcitonin better than C-reactive protein, erythrocyte sedimentation rate, and white blood cell count in predicting DNAemia in patients with sepsis.
abstract: BACKGROUND
  Procalcitonin (PCT) levels can be used to predict bacteremia and DNAemia in patients with sepsis. In this study, the diagnostic accuracy of PCT in predicting blood culture (BC) results and DNAemia, as detected by real-time PCR (RT-PCR), was compared with that of other markers of inflammation commonly evaluated in patients with suspected sepsis, such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count.
  
  
  METHODS
  A total of 571 patients for whom BC, blood RT-PCR, PCT, CRP, ESR, and WBC count were requested for laboratory diagnosis of sepsis were included in the study. Receiver operating characteristic curve analysis was performed to compare the ability of the above biomarkers to predict BC and blood RT-PCR results.
  
  
  RESULTS
  A total of 108 pathogens were identified by BC (79 pathogens, 14.5% positive rate) and/or RT-PCR (90 pathogens, 16.5% positive rate), after exclusion of 26 contaminated samples. The PCT areas under the curve (AUCs) in predicting BC (0.843; 95% CI 0.796-0.890; p < 0.0001) and RT-PCR (0.916; 95% CI 0.888-0.945; p < 0.0001) results were significantly greater than AUCs found for CRP, ESR, and WBC count.
  
  
  CONCLUSIONS
  PCT showed a better diagnostic accuracy than CRP, ESR, and WBC count in predicting DNAemia and bacteremia in patients with suspected sepsis.
authors.affiliation: From the Microbiology Section, Department of Experimental Medicine, University of Perugia, Santa Maria della Misericordia Hospital , Perugia , Italy.
authors.forename: Christian
authors.initials: C
authors.lastname: Leli
authors.forename: Angela
authors.initials: A
authors.lastname: Cardaccia
authors.forename: Marta
authors.initials: M
authors.lastname: Ferranti
authors.forename: Angelica
authors.initials: A
authors.lastname: Cesarini
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Alò
authors.forename: Carla
authors.initials: C
authors.lastname: Ferri
authors.forename: Elio
authors.initials: E
authors.lastname: Cenci
authors.forename: Antonella
authors.initials: A
authors.lastname: Mencacci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D004269:DNA, Bacterial / Q000097:blood*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D004269:DNA, Bacterial; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide
keywords: C-reactive protein; erythrocyte sedimentation rate; procalcitonin; real-time PCR; sepsis