Procalcitonin levels predict to identify bacterial strains in blood cultures of septic patients.
BACKGROUND
We examined whether the values obtained from principal component analysis (PCA) on laboratory tests can be used to predict bacterial infections and identify bacterial strains in blood culture (BC).


METHODS
This study is a single-center retrospective analysis of 315 patients suspected of having sepsis. We applied PCA on procalcitonin (PCT) and laboratory test biomarkers, namely, platelet (PLT), white blood cell, and C-reactive protein (CRP) as well as BC.


RESULTS
Principal component analysis showed that PCT, CRP, and PLT contributions to component 1 were associated with bacterial infection. The number of patients who had BC-negative results, gram-positive cocci (GPC), and gram-negative rods (GNRs) were 124, 28, and 19, respectively. The mean value of component 1 in GNR-positive patients was 1.58±1.41 and was significantly higher than that in GPC-positive patients (0.28±0.87; P<.0001). Furthermore, the mean values of component 1 in both GNR- and GPC-positive patients were significantly higher than that in BC-negative patients (-0.31±0.65; P<.0001 and P<.002, respectively). One certain range showing higher value more than 2.00 for component 1 and -1.00 for component 2 only included GNR-positive patients. There were no BC-positive patients who showed less than -1.00 for component 1.


CONCLUSIONS
The present results obtained by PCA on laboratory tests involving PCT, PLT, white blood cell, and CRP suggest the potential of PCA-obtained values to not only predict bloodstream infection but also identify bacterial strains. This provides some clinical significance in the management of sepsis in acute care.
Department of Emergency and Critical Care Medicine, Trauma and Emergency Center, Hachioji Medical Center of Tokyo Medical University, Tokyo 193-0998, Japan. Electronic address: qqaraitakao@yahoo.co.jp.
Takao
T
Arai
Department of Emergency and Critical Care Medicine, Trauma and Emergency Center, Hachioji Medical Center of Tokyo Medical University, Tokyo 193-0998, Japan.
Shoichi
S
Ohta
Department of Emergency and Critical Care Medicine, Trauma and Emergency Center, Hachioji Medical Center of Tokyo Medical University, Tokyo 193-0998, Japan.
Junya
J
Tsurukiri
Department of Emergency and Critical Care Medicine, Trauma and Emergency Center, Hachioji Medical Center of Tokyo Medical University, Tokyo 193-0998, Japan.
Kenichiro
K
Kumasaka
Department of Emergency and Critical Care Medicine, Trauma and Emergency Center, Hachioji Medical Center of Tokyo Medical University, Tokyo 193-0998, Japan.
Katsuhiro
K
Nagata
Department of Emergency and Critical Care Medicine, Trauma and Emergency Center, Hachioji Medical Center of Tokyo Medical University, Tokyo 193-0998, Japan.
Taihei
T
Okita
Department of Emergency and Critical Care Medicine, Trauma and Emergency Center, Hachioji Medical Center of Tokyo Medical University, Tokyo 193-0998, Japan.
Taishi
T
Oomura
Department of Emergency and Critical Care Medicine, Trauma and Emergency Center, Hachioji Medical Center of Tokyo Medical University, Tokyo 193-0998, Japan.
Akira
A
Hoshiai
Department of Emergency and Critical Care Medicine, Trauma and Emergency Center, Hachioji Medical Center of Tokyo Medical University, Tokyo 193-0998, Japan.
Masaharu
M
Koyama
Department of Emergency and Critical Care Medicine, Trauma and Emergency Center, Hachioji Medical Center of Tokyo Medical University, Tokyo 193-0998, Japan.
Tetsuo
T
Yukioka
D000368:Aged; D000369:Aged, 80 and over; D000071997:Blood Culture; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D005260:Female; D006090:Gram-Negative Bacteria; D016905:Gram-Negative Bacterial Infections / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology; D016908:Gram-Positive Bacterial Infections / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology; D006095:Gram-Positive Cocci; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D025341:Principal Component Analysis; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood* / Q000382:microbiology
D002116:Calcitonin; D002097:C-Reactive Protein