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June 12-13, 2019 | Edinburgh, Scotland
8
th
European Clinical Microbiology and Immunology Congress
&
3
rd
World congress on Biotechnology
Joint Event
Microbiology: Current Research | Volume: 3 | ISSN: 2591-8036
Clinical usefulness of procalcitonin assay to diagnose sepsis: Proposal and evaluation
of PCT-qSOFA
Young Ah Kim
NHIMS Ilsan Hospital, South Korea
S
epsis is a leading cause of morbidity and mortality,
but it is difficult to define sepsis. In sepsis-3, the
recent definition, sepsis is defined as an infection-
induced long-term failure and the quick sequential organ
failure assessment (qSOFA) makes it easy to identify
septic patients. However, qSOFA shows a considerable
discrepancy, compared with first sepsis definition, which
is focusing on abnormal immune responses. The purpose
of this study is to improve the low sensitivity of qSOFA.
We propose 'PCT-qSOFA' by adding 'procalcitonin (PCT),
a useful biological indicator with high sensitivity and
specificity to septicemia diagnosis and evaluated the
clinical usefulness of 'PCT-qSOFA'.
Total 102 cases with laboratory-confirmed bloodstream
infection (BSI) and 102 cases with results of negative blood
culture (BC) repeatedly were included for 1 year (2016.5-
2017.4). BC, PCT test, qSOFA and systemic inflammatory
response syndrome (SIRS) scoring were done in the
same day and BSI cases only included definite pathogens
(Staphylococcus aureus, Enterococcus spp. Klebsiella
pneumoniae
and
Escherichia coli)
. Total 204 cases were
divided to 4 groups such as bacterial sepsis (BSI+ and
SIRS+), BC-negative sepsis (BSI-, SIRS+), BC-positive
without SIRS and control (BSI- and SIRS-).
In results, PCT alone detects 87.5% of sepsis and qSOFA
alone detects 77.2% of sepsis. PCT-qSOFA increased
posttest probability (PCT-qSOFA detects 88.4% of sepsis).
The area under the receiver operating curve (AUC) was
0.701 for PCT and 0.610 for qSOFA in receiver operating
characteristic (ROC) analysis. PCT and qSOFA have
prognostic values. qSOFA can be used in ICU patients
but the revision of cut-off for qSOFA is needed for best
diagnostic performance.
In conclusion, the application of ‘PCT-qSOFA’ is useful for
septicemia diagnosis. We hope that it will help rapid and
accurate detection of sepsis.
Speaker Biography
Young Ah Kim is an expert in laboratory medicine. Her main research
interests are diagnostic methodology of clinical microbiology and
antimicrobial resistance. She is performing studies about an effective
diagnostic strategy of infectious disease and transmission model of
antimicrobial resistance genes in the community.
e:
yakim@nhimc.or.krYoung Ah Kim, Microbiol Curr Res, Volume 3
ISSN: 2591-8036