Virgin Joena1
BACKGROUND
Bacteraemia is the presence of bacteria in the bloodstream that are alive and
capable of reproducing. The incidence of bloodstream infections (BSI) either of
the community-acquired origin or of hospital-acquired origin has dramatically
increased. Identifying patients with high risk of bacteraemia in emergency
department (ED) using predictive models is needed. The present study was
conducted to evaluate the efficacy of procalcitonin as well as other biomarkers as
diagnostic, predictive markers of bacteraemia in an adult patient population in
India.
METHODS
A descriptive observational study was conducted at the ED of a tertiary care
hospital in India. Fifteen years or older patients who were ready to give at least
two samples of blood for blood culture were recruited. Data on demographic
variables, predisposing conditions, clinical presentations, laboratory tests, and
presumptive diagnosis was analysed using SPSS and P value of 0.05 was
considered statistically significant. A logistic model was built using an iterative
procedure which was later simplified into a coefficient-based scoring system.
RESULTS
Out of 78 patients, (66.67 %) from the emergency department and (33.33 %)
from out-patient department (OPD) were enrolled. Among the study population,
40 (51.28 %) were with bacteraemia, and the remaining 38 (48.72 %) had no
bacteraemia. There was no statistically significant difference in levels of
procalcitonin, pulse rate, respiratory rate, systolic blood pressure, diastolic blood
pressure, SPO2, total count, MCV, RDW, MPV, albumin, urea, creatinine between
bacteraemia and no bacteraemia. (P value > 0.05). The mean procalcitonin was
33.02 ± 43.46.
CONCLUSIONS
Although, increased PCT levels can be useful as predictors of bacteremias in the
emergency department, interpretation should be made carefully when deciding
the prescription of antibiotics.
