Original article (Clinical research)

Early diagnostic and prognostic value of procalcitonin and interleukin 6 for catheter-related bloodstream infections in critically ill patients

  • SUI Ming-liang ,
  • WU Chang-jiang ,
  • HUANG Chao-fa ,
  • et al
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  • Department of Critical Care Medicine, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou 215028, China

Online published: 2013-12-03

Abstract

Objective To evaluate the early diagnostic and prognosis value of procalcitonin  (PCT), interleukin 6 (IL-6), and PCT kinetics for central venous catheter related bloodstream infections (CRBSI) in selected critically ill patients. Methods Thirty-six patients received central venous catheter, who were suspected of having CRBSI. All the patient blood samples were obtained for detection of PCT, IL-6 levels, and for blood culture on the first day, and catheter were also obtained for culture. PCT levels were measured on day 1, 2, 3, and 7 after infection. The patients were divided into CRBSI group and non-CRBSI group. The CRBSI group was divided into controlled infection group and non-controlled infection group, and PCT kinetics for prognostic value was observed. Results Fifteen patients were diagnosed as CRBIS (41.67%). Levels of PCT and IL-6 were significantly higher in patients with CRBIS than those without CRBIS on the first infection day (P<0.001 and P<0.005). The ROC curves indicated that the area under the curve (AUC) for PCT and IL-6 was 0.832 and 0.78, respectively. The cutoff points of PCT and IL-6 were set to be 4.3 μg/L and 464.5 ng/L for patients with proven CRBSI, respectively. The corresponding sensitivity, specificity, positive predictive value, and negative predictive value were 80.0% and 77.3%, 95.2% and 66.7%, 92.25% and 61.12%, and 86.95% and 77.76%, respectively. PCT serum levels tended to decrease in patients with controlled CRBSI, whereas in non-controlled patients was proven to remain stably in high level. Conclusion PCT and IL-6 might be valuable early diagnostic parameters for CRBIS with high specificity and negative predictive value, and PCT kinetics has certain predictive value for the prognosis of CRBSI.

Cite this article

SUI Ming-liang , WU Chang-jiang , HUANG Chao-fa , et al . Early diagnostic and prognostic value of procalcitonin and interleukin 6 for catheter-related bloodstream infections in critically ill patients[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2013 , 33(11) : 1491 . DOI: 10.3969/j.issn.1674-8115.2013.11.014

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