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- W4256218896 abstract "To analyse and compare the ability of procalcitonin (PCT), C-reactive protein (CRP) and leukocytes to differentiate true bacteraemia from contaminated blood cultures in patients seen in the emergency department (ED) for an episode of infectious disease. Observational, retrospective and descriptive analytical study of all blood cultures with positive growth extracted in an ED in adult patients (≥18 years) during 2016 and 2017. The follow-up was carried out over a 30-day period to calculate the predictive power and the prognostic performance for true bacteraemia. A total of 266 blood cultures with positive growth were included in the study. Out of these, 154 (57.9%) were considered true bacteraemia and 112 (42.1%) were considered to be contaminated blood cultures. The area under the Receiver Operating Characteristic curve (AUC-ROC) for PCT to predict true bacteraemia was 0.983 (95% CI: 0.972–0.994; p < 0.001) and, considering a cut-off value of ≥0.43 ng/ml, PCT achieved 94% sensitivity, 91% specificity, positive predictive value of 94%, and negative predictive value of 92%. The AUC-ROC obtained for CRP was 0.639 (95% CI: 0.572–0.707, p < 0.001), for leukocytes of 0.693 (95% CI: 0.630–0.756, p < 0.001) and for immature leukocytes (>10% bands) of 0.614 (95% CI: 0.547–0.682, p < 0.001). The mean values for PCT were 3.44 (SD 6.30) ng/ml in true bacteraemia vs 0.16 (SD 0.18) ng/ml in contaminated blood cultures (p < 0.001). In blood cultures with positive growth extracted in an ED, PCT achieves the best prognostic performance of true bacteraemia vs contaminated blood cultures, better than CRP and leukocytes. Analizar y comparar la capacidad de la procalcitonina (PCT), proteína C reactiva (PCR) y leucocitos para diferenciar la bacteriemia verdadera de los hemocultivos (HC) contaminados en los pacientes atendidos en el servicio de urgencias (SU) por un episodio de infección. Estudio observacional, retrospectivo y analítico de todos los HC con crecimiento positivo extraídos en un SU en los pacientes adultos (≥ 18 años) durante los años 2016 y 2017. Se realizó seguimiento durante 30 días y se calculó el poder y rendimiento pronóstico de bacteriemia verdadera. Se incluyeron 266 casos de HC con crecimiento positivo. De ellos se consideraron como bacteriemias verdaderas 154 (57,9%) y como HC contaminantes 112 (42,1%). Para la predicción de bacteriemia verdadera la PCT obtiene un área bajo la curva Receiver Operating Characteristic (ABC-ROC) de 0,983 (IC 95%: 0,972-0,994; p < 0,001) y con un punto de corte de PCT ≥ 0,43 ng/ml se consigue una sensibilidad del 94%, una especificidad del 91%, un valor predictivo positivo de 94% y un valor predictivo negativo de 92%. El ABC-ROC obtenida para la PCR fue de 0,639 (IC 95%: 0,572-0,707; p < 0,001), para el recuento de leucocitos de 0,693 (IC 95%: 0,630-0,756; p < 0,001) y para las formas inmaduras (> 10% cayados) de 0,614 (IC 95%: 0,547-0,682; p = 0,001). Los valores medios al comparar la PCT en las bacteriemias verdaderas y los HC contaminados fueron de 3,44 ng/ml (DE 6,30) frente a 0,16 ng/ml (DE 0,18), p < 0,001. En los HC con crecimiento positivo extraídos en el SU la PCT consigue el mejor rendimiento pronóstico de bacteriemia verdadera diferenciándola de los HC contaminados, mayor que la PCR y los leucocitos." @default.
- W4256218896 created "2022-05-12" @default.
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- W4256218896 date "2019-11-01" @default.
- W4256218896 modified "2023-09-29" @default.
- W4256218896 title "Ability of procalcitonin to differentiate true bacteraemia from contaminated blood cultures in an emergency department" @default.
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- W4256218896 doi "https://doi.org/10.1016/j.eimce.2019.06.002" @default.
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