Evaluation of procalcitonin as a biomarker of bacterial sepsis in adult population in a tertiary healthcare facility in Lagos, Nigeria

*1,2Idakari, C. N., *2,3Efunshile, A. M., 4Akase, I. E., 1Osuagwu, C. S., 1Oshun, P.,
and 1Oduyebo, O. O.

1Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos/Lagos University
Teaching Hospital, Idi-Araba, Lagos, Nigeria

2Department of Medical Microbiology, Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria

3Department of Medical Microbiology, Ebonyi State University, Abakaliki, Nigeria

4Department of Internal Medicine, College of Medicine, University of Lagos/Lagos University
Teaching Hospital, Idi-Araba, Lagos, Nigeria
*Correspondence to: [email protected] and [email protected]

Abstract:
Background: Prompt antibiotic treatment of sepsis improves the outcome, but dependence on clinical diagnosis for empiric therapy leads to overuse of antibiotics which in turn promotes the emergence of antibiotic resistance. Blood culture takes time and molecular diagnosis may not be available or affordable. The use of procalcitonin (PCT) as a biomarker to guide antibiotic therapy in adults is less established compared to children. This study was therefore designed to evaluate the usefulness of PCT as a biomarker to aid early commencement of antibiotics among adult patients with sepsis in a tertiary healthcare facility in Lagos, Nigeria.

Methodology: Three hundred patients with clinical diagnosis of sepsis made by the managing physicians were recruited for the study. Criteria used for clinical diagnosis of sepsis include tachycardia, tachypnea, fever or
hypothermia and presence of leukocytosis, bandemia or leucopenia. The patients were selected using systematic consecutive sampling methods. A sepsis work-up including quick sequential organ failure assessment (qSOFA),
white blood cell count (WCC), aerobic blood culture and estimation of serum PCT levels were done for all the participants. Data were analysed using the Statistical Package for Social Sciences (SPSS) for windows version 25.0.
Sensitivity, specificity, positive, and negative predictive values, accuracy and likelihood ratio of PCT against blood culture, WCC and qSOFA score were determined. Association between variables was measured using Fisher exact
test (with Odds ratio and 95% confidence interval). P-value ˂0.05 was considered statistically significant. Continue reading “Evaluation of procalcitonin as a biomarker of bacterial sepsis in adult population in a tertiary healthcare facility in Lagos, Nigeria”