Diagnostic value of procalcitonin detection in Candida bloodstream infection

Objective To discuss the clinical application value of serum procalcitonin(PCT) in patients with Candida bloodstream infection. Methods The data of 783 hospitalized patients of Tianjin Medical University General Hospital including blood culture and serum PCT test were retrospectively analyzed, and the medical records of patients with Candida or bacterial bloodstream infection were evaluated by univariate and multivariate logistic regression analysis. The comparison of PCT value were carried out among the different blood culture groups using the Mann-Whitney U test. A receiver operating characteristic(ROC) curve was used to determine the diagnostic performance of the PCT. Results The PCT was 0.21 (0.06, 1.02) ng/mL in the 510 patients with negative blood culture, but in 121 patients with Candida infection and 152 patients with bacteria infections, the PCT levels were 1.15 (0.38, 6.85) ng/mL and 2.34 (0.77, 15.12) ng/mL, respectively. There were statistically significant differences in PCT levels among three groups(P<0.05). According to ROC, when the value of PCT was 0.355 ng/mL, the sensitivity was 76.9%, and the specificity was 60.8% with 0.726 area under the curve (AUC) (P<0.01) for the identification of Candida infection by blood cultures. Conclusions Serum PCT levels have a certain diagnostic value for Candida bloodstream infection. In critically ill patients with factors associated with candidemia, the combination of clinical symptoms with PCT as an adjuvant diagnostic marker and other laboratory findings can be used to make a prompt and effective initiation of antifungal therapy. Key words: Procalcitonin; Blood culture; Candida; Blood stream infection