Plasma procalcitonin levels remain low at the onset of gram-positive bacteremia regardless of severity or the presence of shock: A retrospective analysis of patients with detailed clinical characteristics

Abstract Objectives Procalcitonin (PCT) is an early diagnosis marker of sepsis/bacteremia. However, some reports refer to its lower responsiveness to gram-positive bacteremia. We retrospectively evaluated the PCT values at the onset of bacteremia in relation to severity index. Methods Patients with bacteremia caused by two gram-negative bacteria (46 E.coli and 50 K. pneumoniae) and three gram-positive bacteria (45 S.aureus, 56 S.epidermidis, and 10 S.mitis) were studied. The plasma PCT and C-reactive protein (CRP) levels were compared between species and different Sequential Organ Failure Assessment (SOFA) score groups. Results The median PCT level was higher in gram-negative than in gram-positive bacteremia in overall (13.09 vs. 0.50ng/mL, p Conclusions PCT levels are lower in gram-positive bacteremia regardless of SOFA scores or the presence of shock. The conventional sepsis cutoff of 0.5 ng/mL may overlook certain proportions of gram-positive bacteremia.