CRP and PCT as Predictors of Sepsis Cause

Study Overview
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Brief Summary
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The aim of this retrospective study is to determine the predictive role of serum level of procalcitonin (PCT) and c-reactive protein (CRP) in determining the causative agent of sepsis in surgical intensive care unit (ICU) patients. The main question it aims to answer is: what serum level of PCT and CRP is predictive of gram+ and gram- sepsis in patients with positive blood cultures in the surgical ICU. The study will be retrospective and will include all patients with positive blood cultures who were hospitalized in the surgical ICU of University Hospital Osijek in the period from January 2019 to May 2022.

Detailed Description
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PCT is a good biochemical marker of severe bacterial infection. Numerous studies have confirmed its role in the diagnosis of sepsis, especially sepsis with positive blood cultures. This retrospective study will include septic patients who were hospitalised in the surgical ICU between January 2019 and May 2022, and who had at least one positive blood culture. The values of PCT, CRP, white blood cells count and platelets count, as well as the overall outcome of the treatment, will be recorded for the patients included in the research. The aim of the research is to examine the differences in the level of PCT, CRP, white blood cells count and platelets count between patients with gram+ and gram- blood cultures. Also, the predictive value of PCT and CRP in differentiating gram+ from gram- hem will be examined.

Official Title
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CRP and PCT as Predictors of Bloodstream Infections in Surgical Patients With Isolation of G+ and G- Bacteria in 3 Year Period

Conditions
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Sepsis, Gram-Positive Bacteremia, Gram-negative Bacteremia

Intervention / Treatment
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* Diagnostic Test: PCT levels
* Diagnostic Test: CRP levels
* Diagnostic Test: White blood cell count
* Diagnostic Test: Platelet count


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: hospitalisation in surgical ICU diagnosis of sepsis gram+ blood culture isolate gram- blood culture isolate Exclusion Criteria: younger of 18 years old

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Gram negative<br>Patients who had at least one blood culture with a gram- isolate during hospitalisation in the surgical ICU | Diagnostic Test: PCT levels<br>* All patients will have their serum PCT level recorded on the day of the positive blood culture and in the next three days.<br>Diagnostic Test: CRP levels<br>* All patients will have their serum CRP level recorded on the day of the positive blood culture and in the next three days.<br>Diagnostic Test: White blood cell count<br>* All patients will have their white blood cell (WBC) count recorded on the day of the positive blood culture and in the next three days.<br>Diagnostic Test: Platelet count<br>* All patients will have their platelets count recorded on the day of the positive blood culture and in the next three days.<br>|
| Gram positive<br>Patients who had at least one blood culture with a gram+ isolate during hospitalisation in the surgical ICU | Diagnostic Test: PCT levels<br>* All patients will have their serum PCT level recorded on the day of the positive blood culture and in the next three days.<br>Diagnostic Test: CRP levels<br>* All patients will have their serum CRP level recorded on the day of the positive blood culture and in the next three days.<br>Diagnostic Test: White blood cell count<br>* All patients will have their white blood cell (WBC) count recorded on the day of the positive blood culture and in the next three days.<br>Diagnostic Test: Platelet count<br>* All patients will have their platelets count recorded on the day of the positive blood culture and in the next three days.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Predictive level of PCT | Predictive serum level of PCT in differentiating gram+ from gram- blood culture | 4 days | 
| Predictive level of CRP | Predictive serum level of CRP in differentiating gram+ from gram- blood culture | 4 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| White blood cells count | Test for differences in WBC count between patients with gram+ and gram- blood cultures | 4 days | 
| Platelets count | Test for differences in platelets count between patients with gram+ and gram- blood cultures | 4 days | 
| PCT levels and outcome | To examine differences in serum PCT levels between patients who survived and those who died | 4 days | 
| CRP levels and outcome | To examine differences in serum CRP levels between patients who survived and those who died | 4 days |