Presepsin, procalcitonin, interleukin-6, and high-sensitivity C-reactive protein for predicting bacterial DNAaemia among patients with sepsis

• DOI: 10.21037/jtd-24-1714
• Publication Date: 2025-02-28T10:12:16Z
• Authors: Yan Zhou; Di Ren; Yanhong Chen; Sha Wen; Yiwen Zhang; Fei Song; Mei Yang; Michael Eisenhut; James O’Rourke; Ying Li; Shuiqing Gui
• Keywords: Procalcitonin

Anti-infective therapy against pathogens is the key to treatment of sepsis. Metagenomic next-generation sequencing (mNGS) has higher sensitivity than blood culture. The aim this study was use mNGS identify DNAaemia and assess diagnostic accuracy presepsin (PSEP), procalcitonin (PCT), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) in differentiating between bacterial nonbacterial infections patients with This retrospective included sepsis from November 2020 September 2022 Shenzhen Second People's Hospital. Blood samples were sent for culture when diagnosed Plasma PSEP, PCT, IL-6 levels measured using whole specimens that collected analyzed after a diagnosis Area under receiver operating characteristic curve (AUC) used evaluate IL-6, hsCRP prediction detected by 230 rate 53.0% [Gram-positive (GPD), Gram-negative (GND), fungi 18.2%, 37.8%, 10.9%, respectively]. Among GND, Klebsiella most common, followed Escherichia coli; meanwhile, GPD mainly Enterococcus, Aspergillus identified 5 PSEP median values significantly GND non-GND [GND: 1,291 pg/mL, interquartile range (IQR) 456-3,502 pg/mL; non-GND: 707 IQR 332-2,417 P=0.035]. There no significant difference non-GPD groups, or non-fungi groups. Receiver characteristics analysis indicated best cutoff 869 1.14 ng/mL, 85.5 96.2 mg/L, respectively. Logistic regression had predictive value PCT different those non-GPD. Only differed fungal nonfungal DNAaemia. Bacterial-DNAaemia half demonstrated GPD. Meanwhile, only