Diagnostic Impact of Biomarkers in Patients with Healthcare-Associated Infections (HCAI) in a Tertiary Care Hospital
DOI:
https://doi.org/10.26463/rjns.15_2_9Keywords:
Catheter-Associated Urinary Tract Infection, Central Line-Associated Bloodstream Infection, Ventilator-Associated Pneumonia, Surgical Site Infection, ProcalcitoninAbstract
Aims: To evaluate the baseline levels of C-reactive protein (CRP), Procalcitonin (PCT), and total leucocyte count (TLC) in various healthcare-associated infections (HCAIs) to assess their potential as diagnostic markers.
Methods: This two-year retrospective study, conducted in the Department of Neuromicrobiology at NIMHANS, involved data analysis using Microsoft Excel to establish baseline values. Among 123 patients with HCAIs, cases were calssified into Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infection (CLABSI), Ventilator-Associated Pneumonia (VAP), and Surgical Site Infection (SSI). Individuals without HCAIs exhibited normal levels of PCT, CRP, and TLC.
Results: For CAUTI (36 cases): PCT 1.2 ± 0.5 ng/mL, TLC 13,400 ± 3,000 cells/µL, CRP 62.5 ± 15.0 mg/L. For CLABSI (21 cases): PCT 14.8 ± 3.2 ng/mL, TLC 15,100 ± 2,800 cells/µL, CRP 73.4 ± 12.6 mg/L. For VAP (34 cases): PCT 4.7 ± 2.5 ng/mL, TLC 15,200 ± 3,400 cells/µL, CRP 105.2 ± 25.7 mg/L. For SSI (32 cases): PCT 9.3 ± 2.8 ng/mL, TLC 13,500 ± 2,600 cells/µL, CRP 93.4 ± 20.2 mg/L. PCT: Moderate performance across all conditions. TLC: Poor to moderate performance, best in CAUTI and VAP. CRP: Poor performance overall. Sensitivity, specificity, PPV, NPV: PCT: High for CAUTI, VAP, and SSI; moderate for CLABSI. TLC: Moderate to high for CAUTI, VAP, and SSI; moderate for CLABSI. CRP: Moderate for all conditions. Combining markers and clinical assessments is recommended.
Conclusion: Procalcitonin, CRP, and white blood cells are predictive diagnostic markers in HCAIs. Early clinical correlation with appropriate tests facilitates identification and treatment, improving clinical outcomes.
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