234. Can procalcitonin and C-reactive protein determine treatment in blood stream infections?
Session: Poster Abstract Session: Diagnostics: Use of Biomarkers
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • idweek2016 PCT.pdf (306.1 kB)
  • Background: Blood stream infections (BSI) exhibit high mortality and morbidity if antimicrobial therapy is delayed. Determination of insufficiency of treatment initiated is important in terms of prognosis. The purpose of this study was to investigate the relation between antimicrobial therapy in BSIs and procalcitonin (PCT) and C-reactive protein (CRP) kinetics.

    Methods: This study was performed retrospectively with patients with BSI hospitalized in our hospital’s intensive care unit. Patients’ demographic and clinical characteristics and PCT and CRP before starting antibiotic therapy, on the 3rd and 5th days and at the end of treatment were obtained from infection control committee and infectious diseases consultation forms. The data obtained were transferred onto SPSS software for analysis.

    Results: 78 patients with BSI were enrolled. Initial antimicrobial therapy was appropriate in 59 patients, and was adjusted due to being inappropriate in 19. Pre-treatment PCT levels were 1,6 and CRP levels 14,9. On the third day, PCT and CRP levels were 1,5 and 11,6 in patients receiving appropriate treatment and 9.7 and 13.6 in those not receiving appropriate treatment (p=0.039 and p=0.314). On the 5thday, PCT and CRP levels were 1,1 and 10,0 in patients receiving appropriate treatment and 4,4 and 9,7 in those not receiving appropriate treatment (p=0.039). Fifth day PCT and CRP levels were 3,1 and 8,4 in the event of appropriate modification in patients not receiving appropriate treatment on the third day, and 20.8 and 14,7 in those with inappropriate modification (p=0.003 and p=0.244). The mortality rate was 19.2%. Comparison of surviving and non-surviving patients revealed no significant difference in PCT values on days 0 and 3 (p>0.05). PCT values decreased with treatment in surviving patients, but increased in those with a mortal course. PCT was approximately 1.5 times higher (p=0.092) in mortal patients on the third day compared to pre-treatment, and 4 times higher on the fifth day (p=0.011).

    Conclusion:Persistence of elevation in PCT values on the third day of treatment suggests a modification of treatment by suggesting that current treatment is inappropriate. If elevation in PCT persists on the fifth day despite modification in patients receiving it, this may suggest that the modification is also inappropriate.

    Firdevs Aksoy, Assistant Professor1, Gürdal Yilmaz, associated professor1, Murat Aydin, assistant1, Selcuk Kaya, Associate Professor1, Ahmet Eroglu, proffessor2 and Iftihar Koksal, proffessor1, (1)Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey, (2)Deparment of Anesthesiology and Reanimation, Karadeniz Technical University Medical Faculty, Trabzon, Turkey

    Disclosures:

    F. Aksoy, None

    G. Yilmaz, None

    M. Aydin, None

    S. Kaya, None

    A. Eroglu, None

    I. Koksal, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.