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PROCALCITONIN AND SOME FACTORS RELATED TO BLOOD CULTURE RESULTS
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Abstract
Introduction: Sepsis remains a leading cause of mortality in hospitals. The selection of appropriate initial antimicrobial therapy in sepsis is a critical challenge. This study aimed to provide emergency department clinicians with further evidence to guide timely and targeted antibiotic decisions based on the likely causative pathogen. Objectives: This study sought to: (1) determine the association between procalcitonin (PCT) levels and other clinical factors with blood culture results; and (2) determine the association between PCT levels and the type of bacteria isolated (Gram-negative or Gram-positive). Methods: A retrospective chart review was conducted on patients admitted to the General Emergency Department in 2023 who underwent both PCT testing and blood cultures. Results: The mean age of the study population was 71.25 (±14.71) years, and 45.2% (n=118) were male. The overall rate of positive blood cultures was 17.6%. Among positive cultures, 78.3% (n=36) were Gram-negative organisms and 21.7% (n=10) were Gram-positive organisms. The quick Sequential Organ Failure Assessment (qSOFA) score was found to be associated with blood culture positivity. The group with qSOFA ≥ 2 had a positive blood culture rate of 21.6%, nearly twice as high as the other group (12%). Body temperature and plasma PCT concentration were significantly associated with the type of bacteria isolated. Among patients with a body temperature ≤ 38°C and a PCT level < 0.671 ng/ml, Gram-positive bacteria predominated (75%), while Gram-negative bacteria accounted for 25% of isolates. Conversely, among patients with a body temperature > 38°C and/or a PCT level ≥ 0.671 ng/ml, Gram-negative bacteria were overwhelmingly dominant (97.1%), with only 2.9% of isolates being Gram-positive. Conclusion: qSOFA is a clinical factor associated with blood culture results. Body temperature and PCT levels are valuable indicators associated with the type of bacteria isolated in patients newly admitted with sepsis.
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Keywords
Procalcitonin, blood culture, bacteria, sepsis.
References
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