A Julián-Jiménez1, P Gutiérrez-Martín2, A Lizcano-Lizcano3, M A López-Guerrero4, Á Barroso-Manso2, E Heredero-Gálvez5. 1. Servicio de Urgencias, Complejo Hospitalario de Toledo, Toledo, España. Electronic address: agustinj@sescam.jccm.es. 2. Servicio de Urología, Complejo Hospitalario de Toledo, Toledo, España. 3. Servicio de Urgencias, Complejo Hospitalario de Toledo, Toledo, España. 4. Servicio de Medicina Interna, Complejo Hospitalario de Toledo, Toledo, España. 5. Servicio de Microbiología, Complejo Hospitalario de Toledo, Toledo, España.
Abstract
INTRODUCTION: The aim of this study was to analyze and compare the capacity of procalcitonin (PCT), C-reactive protein (CRP), lactate and leukocytes to predict the presence of bacteremia in patients with urinary tract infections (UTIs). METHODS: Observational, retro-prospective analytical study of adult patients (≥15 years) diagnosed with UTI in an emergency department from August 2012 to January 2013. RESULTS: The study included 328 patients diagnosed with UTI, with a mean age of 52±22 years, 74% of whom were women. Of these, 43 (13.1%) had bacteremia. For predicting bacteremia, PCT achieved the largest area under the receiver operating characteristic curve (ROC-AUC) at .993 (95% CI .987-1; P<.001). A cutoff≥1.16ng/mL achieves a sensitivity of 100%, a specificity of 97%, a positive predictive value of 84% and a negative predictive value of 100%. Lactate achieved an ROC-AUC of .844, and CRP achieved only .534. The mean values when comparing PCT levels in patients with UTIs with and without bacteremia were 8.08±16.37 and .34±.37ng/mL, respectively (P<.001). CONCLUSIONS: For patients with UTIs in the emergency department, PCT achieves considerable diagnostic performance for suspecting bacteremia, a performance greater than that of lactate, CRP and leukocytes.
INTRODUCTION: The aim of this study was to analyze and compare the capacity of procalcitonin (PCT), C-reactive protein (CRP), lactate and leukocytes to predict the presence of bacteremia in patients with urinary tract infections (UTIs). METHODS: Observational, retro-prospective analytical study of adult patients (≥15 years) diagnosed with UTI in an emergency department from August 2012 to January 2013. RESULTS: The study included 328 patients diagnosed with UTI, with a mean age of 52±22 years, 74% of whom were women. Of these, 43 (13.1%) had bacteremia. For predicting bacteremia, PCT achieved the largest area under the receiver operating characteristic curve (ROC-AUC) at .993 (95% CI .987-1; P<.001). A cutoff≥1.16ng/mL achieves a sensitivity of 100%, a specificity of 97%, a positive predictive value of 84% and a negative predictive value of 100%. Lactate achieved an ROC-AUC of .844, and CRP achieved only .534. The mean values when comparing PCT levels in patients with UTIs with and without bacteremia were 8.08±16.37 and .34±.37ng/mL, respectively (P<.001). CONCLUSIONS: For patients with UTIs in the emergency department, PCT achieves considerable diagnostic performance for suspecting bacteremia, a performance greater than that of lactate, CRP and leukocytes.
Authors: Nico C Grossmann; Victor M Schuettfort; Christian D Fankhauser; Benedikt Kranzbühler; Jeannine Betschart; Anton S Becker; Thomas Hermanns; Etienne X Keller Journal: Urolithiasis Date: 2022-04-20 Impact factor: 3.436
Authors: Janjam Harikrishna; Alladi Mohan; D P Kalyana Chakravarthi; Abhijit Chaudhury; B Siddhartha Kumar; K V S Sarma Journal: Indian J Med Res Date: 2020-04 Impact factor: 2.375