Etiological and prognostic values of procalcitonin in hospital-acquired pneumonia

BackgroundBiological markers such as procalcitonin, may be helpful for the diagnosis of HAP. Procalcitonin has greater diagnostic accuracy than most commonly used clinical parameters and other biomarkers of infection, such as C-reactive protein and ESR. The aim of the study was to assess the etiological and prognostic values of procalcitonin in adult patients with hospital acquired pneumonia (HAP).Methods15 Patients with a strong suspicion of hospital acquired pneumonia. The diagnosis of HAP depends on the clinical criteria of pulmonary infection and presence of radiological findings. Complete blood picture, sputum culture and sensitivity, ESR, CRP and PCT were obtained at admission and repeated after 2 weeks. PCT was determined with Elecsys BRAHMS PCT in serum of studied patients.ResultsSerum PCT above 0.5 μg/L was considered highly positive for diagnosis of HAP. It was significantly higher at admission (2.72 ± 1.72 μg/L) than after two weeks (1.0 ± 1.91 μg/L). There was a statistical significant decrease in serum levels of procalcitonin (P = 0.002) in response to antibiotic therapy. Also the PCT was significantly higher in patients with bad outcome (2.11–6.0 μg/L) than patients with good outcome (1.76 ± 0.69 μg/L). Procalcitonin was significantly higher among patients with pseudomonas (5.53 ± 0.50 μg/L) and acinetobacter (2.67 ± 0.49 μg/L) and lesser among patients with Escherichia coli (1.38 ± 0.06 μg/L) and MRSA (1.09 ± 0.13 μg/L).ConclusionProcalcitonin was a good etiological and prognostic marker in hospital acquired pneumonia. PCT is the most specific biomarker and has a number of advantages over previous markers.