Abstract

Introduction: In this study, we aimed to determine the relationship between bacteremia and procalcitonin (PCT) and the cut-off value of PCT in detecting bacteremia.

Methods: Adult (>18 years old) patients admitted to our hospital’s emergency department and diagnosed with sepsis between January 1, 2019, and April 1, 2022, were evaluated retrospectively. Patients whose complete blood count, C-reactive protein (CRP), PCT, and biochemical tests were performed and who had two sets of blood cultures taken before antibiotics were started were included in the study. Patients with and without bacteremia were compared in terms of PCT, CRP, leukocyte count, and age. The cut-off value was determined for PCT in detecting bacteremia.

Results: Of the 4036 patients evaluated, 301 patients were included in the study. 174 (57.8%) of the patients were male and 127 (42.2%) were female. Bacteremia was detected in 19% (56) of the cases. The most common pathogen was coagulase-negative staphylococci (46%), and Escherichia coli (23%) was the second most common. A cut-off value of ≥3.29 for PCT has 80% specifity, while the negative predictive value was 89.5% (area under the ROC curve [AUC]= 0.718, 95% confidence interval [CI]=0.663-0.768). There was a low level of positive correlation between leukocyte values and PCT values of the patients (r=0.373, p<0.001). Similarly, there was a low level of positive correlation between CRP values and PCT values (r=0.490, p<0.001).

Conclusion: According to the results of the study, PCT value was found to have a high negative predictive value and high specificity in detecting bacteremia. Therefore, we conclude that PCT value should be measured for early and rapid antibiotic initiation in patients who apply to the emergency outpatient clinic and are suspected of having sepsis.