Abstract:

Objective The aim of this study was to investigate the diagnostic performance of procalcitonin (PCT), high sensitive C-reactive protein (hsCRP), hsCRP/albumin ratio (CAR) and complete blood count (CBC) parameters which can be used as an alternative to the blood culture in the diagnosis of bloodstream infection (BSI). Materials and Methods Medical records of the patients who received inpatient treatment in our hospital between May 2019-May 2020 and who were simultaneously requested for blood culture, PCT, hsCRP, CBC and albumin tests were retrospectively reviewed. The patients were divided into two groups as those with positive blood culture (n=95) and those with negative blood culture (n=157). Blood cultures were performed using the BacT/ALERT 3D (bioMérieux, France) automated blood culture system. The levels of PCT and hsCRP were measured by the Roche Cobas 6000 modular system (Roche Diagnostics, Germany). Complete blood count analysis was performed using the UniCel DxH 800 hematology analyzer (Beckman Coulter, USA). Results A statistically significant difference was found between the hemoculture positive and the hemoculture negative groups in terms of PCT, hsCRP, CAR, neutrophil, lymphocyte, hemoglobin, red blood cell distribution width (RDW), mean platelet volume (MPV), neutrophil/ lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR) platelet/lymphocyte ratio (PLR), MPV/platelet ratio (MPV/PLT) and albumin levels (p<0.05). There was a statistically significant positive correlation between PCT and hsCRP, CAR, MPV, NLR and PLR (p<0.05). In the logistic regression model, PCT (odds ratio: 10.930) and CAR (odds ratio: 1.806) were found to be the strong predictive factors for BSI (p<0.05). Discussion Among the tested markers, PCT and CAR had the best diagnostic performance for BSI. High sensitive CRP and NLR, LMR, PLR, MPV/PLT, RDW, MPV values that can be measured easily, cheaply and quickly by fully automated hemogram devices may be used as additional tests in predicting BSI.

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