Procalcitonin shows moderate accuracy for bloodstream infection detection in retrospective cohort
This retrospective cohort study analyzed 275 positively flagged blood culture bottles (251 isolates analyzed) from a single centre in South India to evaluate the diagnostic utility of procalcitonin (PCT) in bloodstream infections (BSIs). The bacterial distribution was 77.68% Gram-negative and 22.31% Gram-positive pathogens, with Escherichia coli (46.3%) and Klebsiella pneumoniae (44.29%) being the most common Gram-negatives. PCT measurement showed mean levels of 37.87 ng/mL in Gram-negative infections versus 35.09 ng/mL in Gram-positive infections. For BSI detection overall, PCT demonstrated 77.41% sensitivity, 91.04% specificity, and 82.87% diagnostic accuracy.
Safety and tolerability data were not reported in this diagnostic accuracy study. The study has key limitations including its retrospective design and single-centre setting, which may limit generalizability. The overlapping PCT values between Gram-negative and Gram-positive groups and the lack of statistical comparisons for these means further constrain interpretation.
In practice, these observational data suggest PCT may serve as a useful adjunctive biomarker for early BSI detection when interpreted alongside clinical and microbiological findings. However, the marginal difference in mean PCT levels between pathogen groups and the study's design limitations mean PCT cannot reliably differentiate Gram-negative from Gram-positive infections and should not be used as a standalone diagnostic tool.