A Study on Procalcitonin Levels in Patients having Sepsis with a Special Emphasis on Sepsis Due to Tropical Infections: A Cross-sectional Study

Abstract

Background/Aims: To study the levels of Procalcitonin in patients presenting with sepsis, especially those with tropical sepsis at a rural population catering teaching hospital. Study Design: Cross-sectional study. Place and Duration of Study: This cross-sectional study was carried out at the Microbiology and General Medicine Department of SBKS Medical Institute & Research Centre affiliated to Sumandeep Vidyapeeth Deemed to be University. After obtaining necessary approval from the ethics committee this study was conducted between September 2012 and December 2015. Methodology: With the hypothesis that different microbiological agents, especially tropical infections, will evoke diverse host responses in sepsis, this study was undertaken. It was aimed at determining the levels of Procalcitonin in patients presenting with sepsis along with those having tropical sepsis. Patients with age >18 years and diagnosed clinically as sepsis by 1992/2001 definition were included in the study. PCT levels were determined in a total of 155 patients on admission. It was carried out by a semi-quantitative test till March 2015 and then later using a QDx Instacheck quantitative test kit and QDx Instacheck Reader. Ninety eight with tropical sepsis, 46 with non-tropical and 11 with sepsis due to unidentified etiologies were tested making a total of 155 patients. Results: Of the total 155 patients tested, 43 had values of ≤0.5ng/ml, 32 had values of >0.5 to <2 ng/ml, 55 had ≥2 to <10ng/ml and 25 had values of ≥10 ng/ml. Thus a larger number of patients showed the values ranging between 2ng/ml and 10ng/ml. Conclusions: Overall PCT was found raised in mainly bacterial, fungal and malarial infections especially with the values of ≥2 to <10 ng/ml whereas those with dengue had values of ≤0.5ng/ml. Thus PCT values were not much useful in differentiating infections due to bacteria, fungi or malaria but those with dengue had values ≤0.5ng/ml. Values of >10ng/ml were mainly associated with severity and mortality.