Correlation Between Time to Positivity Blood Culture and Procalcitonin on Bacteremia Patient

Nelly Elfrida Samosir, Ricke Loesnihari, Adi Koesoema Aman

Abstract


Introduction

Bacteremia causes a high mortality rate. Detection of bacteremia is needed as quickly as possible. The gold standard for bacteremia is blood culture which takes between 24-48 hours. Procalcitonin (PCT) is a marker of infection that is caused by bacteria that can be detected quickly in 2-6 hours. Time to positivity (TTP) blood culture is affected by the initial amount of bacteria and the addition of procalcitonin stimulated by bacteria that causes bacteremia where short TTP and high PCT show bad clinical conditions.

 

Materials and Methods

Analitical cross sectional research on patients with bacteremia. Fourty six bacteremia cases become the sample of research. Time to Positivity is calculated with Bactec 9050 and Procalcitonin is analyzed with mini VIDAS B.R.A.H.M.S. Examination is conducted in Department of Clinical Pathology FK-USU/ Installation of Clinical Pathology of RSUP H. Adam Malik, Medan, June – October 2016.

 

Results

There was significant correlation between Time to Positivity blood culture and procalcitonin on bacteremia patients (p<0.05). There was no significant correlation between Time to Positivity and procalcitonin on bacteremia which was caused by gram-positive bacteria or gram-negative bacteria (p>0.05). Procalcitonin was significantly higher on bacteremia which was caused by gram-negative bacteria compared to gram-positive bacteria (p<0.05).

 

Conclusion

There was significant correlation between Time to Positivity blood culture and procalcitonin on bacteremia patients. Significantly higher levels of procalcitonin in cases of bacteremia are more likely to be caused by Gram-negative bacteria than Gram-positive bacteria


Keywords


Time to Positivity, Blood Culture, Procalcitonin, Bacteremia

References


Oussalah A, janina f, Pierre FT, Pharm D , Nejla A, Isabelle AG, et al. Diagnostic accuracy of procalcitonin for predicting blood culture results in patients with suspected bloodstream infection. Medicine, 2015; 94(44):e1774

Hattori T, Nishiyama H, Kato H, Ikegami S, Nagayama M, Asami S, et al. Clinical value of procalcitonin for patients with suspected bloodstream infection. Am J Clin Pathol, 2014; 141: 43-51.

Ning Y, Hu R, Yao G, Bo S. Time to positivity of blood culture and its prognostic value in bloodstream. 2016; 35(4): 619-24

Willmann M, Kuebart I, Vogel W, Flesch I, Market U, Marschal M, et al. Time to positivity as prognostic tool in patiens with pseudomonas aeruginosa bloodstream infection. Journal of Infection, 2013; 67(5): 416-23.

Hsu M, Huang Y, Hsu H, Liao C. Sequential time to positivity of blood cultures can be a predictor of prognosis of patients with persistent Staphylococcus aureus bacteremia. Clin Microbiol Infect, 2014; 20: 892-8.

Tang PC, Lee CC, Li C, Li M, Ko W, Lee N. Time-to-positivity of blood culture: An independent prognostic factor of monomicrobial Pseudomonas aeruginosa bacteremia, Journal of Microbiology, Immunology and Infection (2015), http://dx.doi.org/10.1016/j.jmii.2015.08.014

Liao C, Lai C, Hsu M, Huang Y, Chu F, Hsu H, et al. Correlation between time to positivity of blood cultures with clinical presentation and outcomes in patients with Klebsiella pneumoniae bacteremia: Prospective cohort study. Clin Microbiol Infect, 2009; 15: 1119-1125.

Peralta G, Roitz M, Sanchez M, Garrido J, Ceballos B, Rodriguez-Lera M, et al. Time to positivity in patients with Escherichia coli bacteremia. Clin Microbiol Infect, 2007; 13: 1077-82.

Peralta G, Rodriguez-Lera M, Garrido J, Ansorena L, Roiz P. Time to positivity in blood cultures of adults with Streptococcus pneumoniae bacteremia. BMC Infect Dis, 2006; 6:79

Pavic M, Bronic A, Kopcinovic LM. Procalcitonin in systemic and localized bacterial infection. Biochemia Medica, 2010; 20(2): 236-41.

Guo S, Zhou Y, Hu Q, Yao J, Wang H. Procalcitonin Is a marker of Gram-negative bacteremia in patients with sepsis. The American Journal of the Medical Sciences, 2015; 349: 499-504.

Meisner M. Procalcitonin-biochemistry and clinical diagnosis. 1st Ed., Bremen, UNI-MED, 2010; 35-36

Gopi A, Ravikumar K, Ambarish M, Shwethalatha N, Shree S, Ashwini K, et al. Time to positivity of microorganism with BACTEC 9050:- An 18-month study among children of 28 days to 60 months in a South Indian Tertiary Hospital. Int J Microbiol Res, 2011; 2(1): 12-7.

Shah SS, Downes KJ, Elliott MR, Bell LM, McGowan KL, Metlay JP. How long does it take to "rule out"bacteremia in children with central venous catheters?. American Academy of Pediatrics, 2008; 121: 135-41

Alfouzan W, Azizieh F, Dhar R. Correlation between inoculum volume, positivity rates, and microorganisms isolated from blood cultures. African Journal of Microbiology Research, 2014; 8(28): 2705-2709.

Dolma K, Gautam D, Devi K, Singh T. A comparative study on the efficacy of first vs. second blood culture set in the diagnosis of bacteremia in Central Referral Hospital, Sikkim, India. International Journal of Medical Research and Review, 2016; 4(7): 1243-1249.

Abe R, Oda S, Sadahiro T, Nakamura M, Hirayama Y, Tateishi Y, et al. Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia. Critical Care, 2010; 14(2):R27. doi: 10.1186/cc8898.

Asaad A. Coagulase-negative Staphylococci clinical isolates: infectious or contaminant, that is the question. Int J Clin Med Microbiol, 2016; 1 : 102. doi: https://doi.org/10.15344/2456-4028/2016/102.

Becker K, Heilmann C, Peters G. Coagulase-negative Staphylococci. Clinical Microbiology Reviews, 2014; 27: 870-926.

Savithri M, Iyer V, Jones M, Yarwood T, Looke D, Kruger P, et al. Epidemiology and significance of coagulase-negative staphylococci isolated in blood cultures from critically ill adult patients. Crit Care Resusc, 2011; 13: 103-7.

McGowan K, Foster J, Coffin S. Out patient pediatric blood cultures: Time to positivity. Pediatrics, 2000; 106 (2 Pt 1):251-5.

Ruimy R, Lefevre L, Andremont A. Short time to positivity in blood culture with clustered Gram-positive cocci on direct smear examination is highly predictive of Staphylococcus aureus. Am J Infect Control, 2005; 33: 304-6.

Garcia-Vazquez E, Fernandez-Rufete A, Hernandez-Torres A, Canteras M, Ruiz J, Gomez J. When is coagulase-negative Staphylococcus bacteremia clinically significant?. Scandinavian Journal of Infectious Diseases, 2013; 45: 664-671.

Kassis C, Rangaraj G, Jiang Y, Hachem RRI. Differentiating culture samples representing coagulase-negative staphylococcal bacteremia from those representing contamination by use of time to positivity and quantitative blood culture methods. Journal of Clinical Microbiology, 2009; 47(10): 3255-3260.

Leli C, Ferranti M, Moretti A, Dhahab ZSA, Cenci E, Mencacci A. Procalcitonin levels in Gram-positive, Gram-negative, and fungal bloodstream. Disease Markers, 2015; 2015, Article ID 701480, 8 pages, 2015, https:doi.org//10.1155/2015/701480.

Charles E, Ladoire S, Aho S, Quenot J, Doise J, Prin S, et al. Serum procalcitonin elevation in critically ill patients at the onset of bacteremia caused by either Gram-negative or Gram-positive bacteria. BMC Infect Dis, 2008; 8:38.

Wanatabe Y, Oikawa N, Hariu M, Fuke R, Seki M. Ability of procalcitonin to diagnose bacterial infection and bacteria types compared with blood culture findings. International Journal of General Medicine, 2016; 9: 325-331.

Li S, Rong H, Guo Q, Chen Y, Zhang G, Yang J. Serum procalcitonin levels distinguish Gram-negative bacterial sepsis from Gram-positive bacterial and fungal sepsis. J Res Med Sci. 2016; 21:39

Kumar S, Ingle H, Prasad DVR, Kumar H. Recognition of bacterial infection by innate immune sensors. Critical Reviews in Microbiology, 2013;39(3):229-246.

Yan S, Sun L, Jia H, Gao W, Yang J, Zhang G. Procalcitonin levels in bloodstream infections caused by different sources and species of bacteria. American Journal of Emergency Medicine. 2017; 35: 579-583.

Nieuwkoop C, Bonten T, Wout J, Kuijper E, Groeneveild G, Becker M, et al. Procalcitonin reflects bacteremia and bacterial load in urosepsis syndrome: A prospective observational study. Critical Care, 2010; 14(6): R206.

Schuetz P, Mueller B, Trampuz A. Serum procalcitonin for discrimination of blood contamination from bloodstream infection due to coagulase-negative staphylococci. Infection, 2007; 35: 352-355.




DOI: http://dx.doi.org/10.24293/ijcpml.v25i3.1506

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