Sepsis remains the leading cause of death in cancer patients. Biomarkers allow an objective and reliable possibility of rapid prediction of the septic process. The purpose of the study was to assess the prognostic significance of a rapid and accessible verification of the sepsis pathogens with biomarkers – procalcitonin and Platelia Candida Ag Plus
The study included 440 patients with clinical manifestations of the inflammatory response in intensive care units, oncological and oncohematological departments. Levels of procalcitonin and Platelia Candida Ag Plus were determined by ELISA together with the blood sterility testing using the BacT/ALERT 3D analyzer.
The most common pathogens (78%) were bacteria (K. pneumoniae. E. coli, less often other members of the Enterobacteriaceae family, P. aeruginosa, A. baumannii, E. faecalis, E. Faecium, etc.); yeasts of Candida spp. – 22%; mixed pathogens – 7.5%, comprising 37.5% bacteria and 62.5% bacterial-fungal pathogens. Positive blood cultures were found in 106 (24.1%) patients. The results of a blood culture took on average 3 days. The use of two biomarkers allowed predicting a pathogen in the first hours after the blood collection. An increase in the levels of one biomarker in 137 (31.1%) patients with negative blood cultures indicated the presence of bacterial, fungal or bacterial-fungal infections. The blood culture examination together with determination of biomarkers improved verification of sepsis pathogens in 243 (55.2%) patients with clinical manifestations of sepsis and hastened preliminary results and empirical therapy.
The study of the blood culture and determination of levels of the biomarkers allowed the prediction of pathogens in 243 (55.2%) patients with clinical manifestations of sepsis. 197 (44.8%) patients with negative blood cultures and normal levels of biomarkers required additional tests.
Clinical trial identification
Legal entity responsible for the study
Ministry of Health of the Russian Federation.
Has not received any funding.
All authors have declared no conflicts of interest.