{"title":"对重症监护病房的菌尿患者进行 PCT 和 CRP 联合检测优于单独检测:一项回顾性研究。","authors":"Guo-Ming Zhang, Xu-Xiao Guo","doi":"10.1186/s40001-024-02036-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Previous studies on PCT for urinary tract infections (UTI) have focused primarily on minors. This study investigated the predictive value of the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) level and procalcitonin (PCT) level in adult patients with bacteriuria in IUC.</p><p><strong>Methods: </strong>This case‒control study included 85 patients with bacteriuria (PB) in the ICU from March 2021 to Jan 2024 based on positive urine culture results and a control group (n = 136) from Jan 2024 to March 2024. Patient data were collected using a hospital information management system. ROC curves of the NLR, CRP and PCT were use to predict the PB.</p><p><strong>Results: </strong>The AUCs of the NLR, CRP and PCT for the prediction of PB in ICU were 0.711 (95% CI 0.644-0.772), 0.855 (95% CI 0.800-0.900), and 0.884 (95% CI 0.832-0.924), respectively; the optimal thresholds were 8.02, 18.52 mg/L, and 0.215 ng/mL, respectively; the sensitivities were 69.0 (95% CI 56.9-79.5), 90.1 (95% CI 80.7-95.9), and 83.1 (95% CI 72.3-91.0), respectively; and the specificities were 67.6 (95% CI 59.1-75.4), 68.4 (95% CI 59.9-76.1), and 80.9 (95% CI 73.3-87.1), respectively. The negative predictive value (NPV) of CRP is greater than that of PCT. In bacteriuria caused by Candida infections, CRP and PCT have higher sensitivity and NPV.</p><p><strong>Conclusions: </strong>Combined CRP and PCT testing is more helpful for diagnosing bacteriuria. CRP and PCT have higher sensitivity and NPV in diagnosing bacteriuria caused by Candida infection.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363691/pdf/","citationCount":"0","resultStr":"{\"title\":\"Combining PCT with CRP is better than separate testing for patients with bacteriuria in the intensive care unit: a retrospective study.\",\"authors\":\"Guo-Ming Zhang, Xu-Xiao Guo\",\"doi\":\"10.1186/s40001-024-02036-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Previous studies on PCT for urinary tract infections (UTI) have focused primarily on minors. This study investigated the predictive value of the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) level and procalcitonin (PCT) level in adult patients with bacteriuria in IUC.</p><p><strong>Methods: </strong>This case‒control study included 85 patients with bacteriuria (PB) in the ICU from March 2021 to Jan 2024 based on positive urine culture results and a control group (n = 136) from Jan 2024 to March 2024. Patient data were collected using a hospital information management system. ROC curves of the NLR, CRP and PCT were use to predict the PB.</p><p><strong>Results: </strong>The AUCs of the NLR, CRP and PCT for the prediction of PB in ICU were 0.711 (95% CI 0.644-0.772), 0.855 (95% CI 0.800-0.900), and 0.884 (95% CI 0.832-0.924), respectively; the optimal thresholds were 8.02, 18.52 mg/L, and 0.215 ng/mL, respectively; the sensitivities were 69.0 (95% CI 56.9-79.5), 90.1 (95% CI 80.7-95.9), and 83.1 (95% CI 72.3-91.0), respectively; and the specificities were 67.6 (95% CI 59.1-75.4), 68.4 (95% CI 59.9-76.1), and 80.9 (95% CI 73.3-87.1), respectively. The negative predictive value (NPV) of CRP is greater than that of PCT. In bacteriuria caused by Candida infections, CRP and PCT have higher sensitivity and NPV.</p><p><strong>Conclusions: </strong>Combined CRP and PCT testing is more helpful for diagnosing bacteriuria. CRP and PCT have higher sensitivity and NPV in diagnosing bacteriuria caused by Candida infection.</p>\",\"PeriodicalId\":11949,\"journal\":{\"name\":\"European Journal of Medical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363691/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Medical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s40001-024-02036-7\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Medical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40001-024-02036-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
摘要
背景:以往针对尿路感染(UTI)的 PCT 研究主要集中在未成年人身上。本研究调查了中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)水平和降钙素原(PCT)水平对ICU细菌尿成年患者的预测价值:这项病例对照研究纳入了2021年3月至2024年1月期间重症监护室中基于阳性尿培养结果的85例细菌尿(PB)患者,以及2024年1月至2024年3月期间的对照组(n = 136)。患者数据通过医院信息管理系统收集。利用 NLR、CRP 和 PCT 的 ROC 曲线预测 PB:NLR、CRP 和 PCT 预测 ICU 中 PB 的 AUC 分别为 0.711(95% CI 0.644-0.772)、0.855(95% CI 0.800-0.900)和 0.884(95% CI 0.832-0.924);最佳阈值分别为 8.02、18.52 mg/L 和 0.灵敏度分别为 69.0(95% CI 56.9-79.5)、90.1(95% CI 80.7-95.9)和 83.1(95% CI 72.3-91.0);特异性分别为 67.6(95% CI 59.1-75.4)、68.4(95% CI 59.9-76.1)和 80.9(95% CI 73.3-87.1)。CRP 的阴性预测值 (NPV) 要高于 PCT。对于念珠菌感染引起的菌尿,CRP 和 PCT 的敏感性和 NPV 都更高:结论:联合检测 CRP 和 PCT 更有助于诊断菌尿。在诊断念珠菌感染引起的菌尿时,CRP 和 PCT 具有更高的灵敏度和 NPV。
Combining PCT with CRP is better than separate testing for patients with bacteriuria in the intensive care unit: a retrospective study.
Background: Previous studies on PCT for urinary tract infections (UTI) have focused primarily on minors. This study investigated the predictive value of the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) level and procalcitonin (PCT) level in adult patients with bacteriuria in IUC.
Methods: This case‒control study included 85 patients with bacteriuria (PB) in the ICU from March 2021 to Jan 2024 based on positive urine culture results and a control group (n = 136) from Jan 2024 to March 2024. Patient data were collected using a hospital information management system. ROC curves of the NLR, CRP and PCT were use to predict the PB.
Results: The AUCs of the NLR, CRP and PCT for the prediction of PB in ICU were 0.711 (95% CI 0.644-0.772), 0.855 (95% CI 0.800-0.900), and 0.884 (95% CI 0.832-0.924), respectively; the optimal thresholds were 8.02, 18.52 mg/L, and 0.215 ng/mL, respectively; the sensitivities were 69.0 (95% CI 56.9-79.5), 90.1 (95% CI 80.7-95.9), and 83.1 (95% CI 72.3-91.0), respectively; and the specificities were 67.6 (95% CI 59.1-75.4), 68.4 (95% CI 59.9-76.1), and 80.9 (95% CI 73.3-87.1), respectively. The negative predictive value (NPV) of CRP is greater than that of PCT. In bacteriuria caused by Candida infections, CRP and PCT have higher sensitivity and NPV.
Conclusions: Combined CRP and PCT testing is more helpful for diagnosing bacteriuria. CRP and PCT have higher sensitivity and NPV in diagnosing bacteriuria caused by Candida infection.
期刊介绍:
European Journal of Medical Research publishes translational and clinical research of international interest across all medical disciplines, enabling clinicians and other researchers to learn about developments and innovations within these disciplines and across the boundaries between disciplines. The journal publishes high quality research and reviews and aims to ensure that the results of all well-conducted research are published, regardless of their outcome.