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Comparative cross-sectional descriptive study between Procalcitonin and Ultrasensitive C-reactive Protein and their ability to predict positive blood cultures in hemodialysis patients admitted for suspected bloodstream infection related to the catheter at the IGSS Quetzaltenango General Hospital
Introduction: Procalcitonin is an important biomarker in sepsis and as a guide in antibiotics, however, in kidney patients having an inflammatory process, its use is controversial. The objective of this study is to evaluate the sensitivity and usefulness as a comparative diagnostic marker to detect blood infections. with C-Reactive Protein in patients on hemodialysis.
Material and Methods: 101 patients in total, 70 had a culture and Procalcitonin and 90 had a culture and Protein C. Both biomarkers were taken at the time of admission, with the result of the blood culture expected in about 5 days. It was analyzed in SPSS Statistics and the discriminatory capacity was compared.
Results: A total of 42 patients had a positive blood culture, the majority were male (66%) and by means of the ROC curve, the area under the curve (AUC) of Procalcitonin was 0.585, with a 95% CI (0.439-0.731). ), while for C-reactive protein an AUC of 0.819, 95% CI (0.729-0.902) was obtained.
Conclusions: Procalcitonin has a weak discriminatory capacity that does not reach the minimum AUC standard according to the Youden index , which is above 0.7. Procalcitonin presents an AUC of 0.59 compared to C-reactive protein, which presents an AUC of 0.819, which is above the average. , which makes it more useful to use C-reactive protein in catheter-related infections, with a Youden index of 0.725 (72%) Sensitivity, Specificity of 0.811 (81.1%) with an Ultrasensitive PCR cut-off point of 8.18, according to the index by Youden .