The Role of Procalcitonin in Differentiating Between Gram-Negative and Gram-Positive Sepsis

Introduction: Detecting the agent group in sepsis patients with culture positivity is crucial in determining our treatment scheme. We aimed to evaluate the diagnostic accuracy of procalcitonin (PCT) levels in distinguishing between different pathogen groups in sepsis patients with proven bacteremia. Materials & Methods: Records of patients hospitalized in ICU were retrospectively investigated over 28 months were retrospectively investigated confirmed microbiologically to have a positive blood culture result. The patients were evaluated in two groups regarding gram-negative (GN) and gram-positive bacteria based on the findings of blood culture and Gram staining. Age, gender, APACHE II score, hospital stay, mortality, and laboratory parameters were compared in both groups. Of 894 patients followed up in ICU during 28 months, 56 sepsis patients confirmed microbiologically to have blood culture positivity were included. Results: While GN bacteria grew in the blood cultures of 26 (46.4%) patients, 30 (53.6%) patients were found to have GP bacteria. The level of PCT was significantly higher in the GN group, compared to that of the GP group (p=0.003). There were no significant differences in CRP values and APACHE II scores between the GN and GP groups (p=0.147 and p=0.633, respectively). Additionally, no statistically significant difference was determined between the GN and GP groups regarding the mortality rate (p=0.712). Leukocyte, neutrophil, lymphocyte, platelet, and albumin values of both groups were also similar. Conclusionː PCT was found to be a useful marker in predicting the pathogen groups in early treatment management of patients diagnosed with sepsis.