Predictive role of selected biomarkers in differentiating gram-positive from gram-negative sepsis  in surgical patients: a retrospective study

Nenad Nešković; Domagoj Drenjančević; Slavica Kvolik; Sonja Škiljić; Dino Budrovac; Ivana Haršanji Drenjančević

doi:10.5114/ait.2023.134214

eISSN: 1731-2531
ISSN: 1642-5758

Anaesthesiology Intensive Therapy

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abstract:

Original article

Predictive role of selected biomarkers in differentiating gram-positive from gram-negative sepsis in surgical patients: a retrospective study

Nenad Nešković

^{1, 2}

,

Domagoj Drenjančević

^{2, 3}

,

Slavica Kvolik

^{1, 2}

,

Sonja Škiljić

^{1, 2}

,

Dino Budrovac

^{1, 2}

,

Ivana Haršanji Drenjančević

^{1, 2}

Department of Anaesthesiology, Resuscitation, and Intensive Care, Osijek University Hospital, Croatia
Faculty of Medicine, University Josip Juraj Strossmayer Osijek, Croatia
Department of Clinical Microbiology and Hospital Infections, Osijek University Hospital, Croatia

Anaesthesiol Intensive Ther 2023; 55, 4: 319–325

DOI: https://doi.org/10.5114/ait.2023.134214

Online publish date: 2023/12/30

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AMA

Nešković N, Drenjančević D, Kvolik S, Škiljić S, Budrovac D, Drenjančević I. Predictive role of selected biomarkers in differentiating gram-positive from gram-negative sepsis  in surgical patients: a retrospective study. Anaesthesiology Intensive Therapy. 2023;55(5):319-325. doi:10.5114/ait.2023.134214.

APA

Nešković, N., Drenjančević, D., Kvolik, S., Škiljić, S., Budrovac, D.,  & Drenjančević, I. (2023). Predictive role of selected biomarkers in differentiating gram-positive from gram-negative sepsis  in surgical patients: a retrospective study. Anaesthesiology Intensive Therapy, 55(5), 319-325. https://doi.org/10.5114/ait.2023.134214

Chicago

Nešković, Nenad, Domagoj Drenjančević, Slavica Kvolik, Sonja Škiljić, Dino Budrovac,  and Ivana Haršanji Drenjančević. 2023. "Predictive role of selected biomarkers in differentiating gram-positive from gram-negative sepsis  in surgical patients: a retrospective study". Anaesthesiology Intensive Therapy 55 (5): 319-325. doi:10.5114/ait.2023.134214.

Harvard

Nešković, N., Drenjančević, D., Kvolik, S., Škiljić, S., Budrovac, D.,  and Drenjančević, I. (2023). Predictive role of selected biomarkers in differentiating gram-positive from gram-negative sepsis  in surgical patients: a retrospective study. Anaesthesiology Intensive Therapy, 55(5), pp.319-325. https://doi.org/10.5114/ait.2023.134214

MLA

Nešković, Nenad et al. "Predictive role of selected biomarkers in differentiating gram-positive from gram-negative sepsis  in surgical patients: a retrospective study." Anaesthesiology Intensive Therapy, vol. 55, no. 5, 2023, pp. 319-325. doi:10.5114/ait.2023.134214.

Vancouver

Nešković N, Drenjančević D, Kvolik S, Škiljić S, Budrovac D, Drenjančević I. Predictive role of selected biomarkers in differentiating gram-positive from gram-negative sepsis  in surgical patients: a retrospective study. Anaesthesiology Intensive Therapy. 2023;55(5):319-325. doi:10.5114/ait.2023.134214.

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Introduction:
Patients after major surgery are at high risk of developing sepsis, which is accompanied by elevated serum levels of C-reactive protein (CRP) and procalcitonin (PCT). This study aimed to examine the differences in serum biomarker levels concerning the causative agent of sepsis in surgical patients.

Material and methods:
A retrospective study was carried out in the surgical intensive care unit (ICU) and included 81 septic patients admitted from January 2019 to May 2022, who had positive blood cultures (BC). Serum levels of PCT, CRP, white blood cells (WBC) and platelet counts were recorded on the day of the positive BC and over the following 3 days.

Results:
Patients with gram(–) sepsis had significantly higher PCT levels, and lower platelet count compared to patients with gram(+) sepsis. High PCT and low platelets levels in all measurements were a significant predictor of gram(–) isolate with the highest predictive value on the third day after BC sampling, with AUROC 0.821 (95% CI: 0.692–0.950), P = 0.001, and AUROC 0.676 (95% CI: 0.541–0.811), P = 0.02, respectively. In multivariate logistic regression, platelets the day after BC sampling and PCT on the third day made a significant contribution in distinguishing gam(+) from gram(–) BC. Age and high serum CRP levels were significant predictors of poor outcomes.

Conclusions:
PCT and platelets may be useful biomarkers for predicting the causative agent of sepsis in surgical patients.

keywords:

Predictive role of selected biomarkers in differentiating gram-positive from gram-negative sepsis in surgical patients: a retrospective study

Nenad Nešković 1, 2 , Domagoj Drenjančević 2, 3 , Slavica Kvolik 1, 2 , Sonja Škiljić 1, 2 , Dino Budrovac 1, 2 , Ivana Haršanji Drenjančević 1, 2

blood culture, critical care, C-reactive protein, procalcitonin, sepsis, surgery

Nenad Nešković

^{1, 2}

,

Domagoj Drenjančević

^{2, 3}

,

Slavica Kvolik

^{1, 2}

,

Sonja Škiljić

^{1, 2}

,

Dino Budrovac

^{1, 2}

,

Ivana Haršanji Drenjančević

^{1, 2}