Publication: Point of care procalcitonin for early detection of bacterial coinfection in patients with severe dengue in the intensive care unit: A prospective cohort study
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Date
2022
Authors
Azmi, Wan Nur Aida Wan
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Abstract
Background: Early detection of bacterial coinfection in severe dengue remains challenging. Point-of care (POC) Procalcitonin (PCT) may fulfil this role, but its performance has not been investigated. We therefore aimed to evaluate the performance of POC PCT for early detection of bacterial coinfection in patients with severe dengue admitted to the intensive care units (ICU). Methodology: In this dual-centre prospective cohort study, we analysed PCT level in severe dengue patients with and without bacterial coinfection upon their ICU admission. The diagnostic performance of PCT for the coinfection was determined through analysis of the receiver operating characteristics curve. Results: Fifty severe dengue patients were enrolled over a 1-year period. Fourteen (28.0%) of these patients had bacterial coinfection on ICU admission. PCT was significantly higher in patients with the coinfection than those without (36.2 [SD = 41.8] versus 3.6 [SD = 5.6] ng/mL, P = 0.012). The AUC of 0.768, ideal cut-off of >4.6 ng/mL, sensitivity of 64.3% and specificity of 83.3% revealed that PCT was a good marker for detecting bacterial coinfection in our severe dengue cohort. Conclusion: POC PCT provides early detection of bacterial coinfection with a good performance in severe dengue although further studies are warranted to validate these findings.
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Keywords
Procalcitonin , Coinfection