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| Study on the value of serum procalcitonin combined with the intestinal microbiota composition on diagnosis of pathogens in patients with nosocomial infection |
| Zhang Yu-bao, Wang Jin-quan, Wang Di, Tao Xiao-gen, He Jian-san |
| Intensive Care Unit, of Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230000, China |
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Abstract Objective To analyze the clinical value of serum procalcitonin (PCT) combined with the intestinal microbiota composition for the early diagnosis of gram-negative (G-) bacteria and gram-positive (G+) bacteria in ICU patients with nosocomial infection. Methods From December 2015 to December 2018, the clinical data of 110 patients with nosocomial infection in ICU was analyzed. And the patients were divided into the G+ bacterial group (47 cases) and the G- bacterial group (63 cases). The clinical data, serum PCT concentration and the intestinal microbiota composition of the two groups were compared. According to the analysis of ROC curve, the optimal diagnostic values of serum PCT and the intestinal microbiota composition for the diagnosis of pathogens were determined. Results Compared with the patients in the G+ bacterial group, the PCT concentration, blood glucose, heart rate, the score of SIRS and APACHEⅡ of patients in G- bacterial group were higher (P＜0.05). And the ratio of fecal G- bacteria to G+bacteria was higher in G- bacterial group (62.7% vs. 32.9%, P＜0.01). When the diagnostic cut-off point was PCT≥1.02 ng/mL, the area under the curve (AUC) was 0.82 (0.74~0.90), the sensitivity was 73.02%. When the diagnostic cut-off point was the ratio of fecal G- bacteria to G+ bacteria≥3, AUC was 0.81 (0.73~0.89), the sensitivity was 63.49%.The sensitivity of PCT combined with the gut microbiota composition for diagnosing G- bacteria was 82.54%, AUC was 0.77(0.67-0.86). The sensitivity was higher than that of PCT or fecal flora analysis alone (P＜0.01). Conclusion The serum PCT combined with the gut microbiota composition had the high sensitivity and accuracy for diagnosing pathogens of the patients with nosocomial infectionin ICU. It is worthy of clinical application.
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Corresponding Authors:
Wang Jin-quan, E-mail: jqwang604@163.com
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