The Role of Serum Procalcitonin Levels in Predicting Ascitic Fluid Infection in Ascitic Patients Admitted to Zagazig University Hospital in 2014.

Abstract

Background: It is difficult to diagnose spontaneous bacterial peritonitis (SBP) early in ascitic patients. The aim of the study was to measure serum procalcitonin (PCT) levels to obtain an early diagnostic indication of SBP in ascitic patients. Methods: A total of 62 patients (mean age: 54.4 ± 10.7, 77.4% were males) hospitalized due to cirrhosis (n=57) or non-cirrhosis related (n=5) ascites were included in this study. Spontaneous bacterial peritonitis (SBP, 19.4%), culture-negative SBP (35.5%), bacterascites (6.5%), sterile ascites (30.6%) and non-cirrhotic ascites (8.1%) groups were compared in terms of procalcitonin levels in predicting ascites infection. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of procalcitonin levels. Results: Culture positivity was determined in 25.8% of overall population. Serum procalcitonin levels were determined to be significantly higher in patients with positive bacterial culture in ascitic fluid compared to patients without culture positivity (median (min-max): 3.35 (0.05-6.4) vs. 0.2 (0.05-1.9), p=0.000). Using ROC analysis, a serum procalcitonin level of >1.9 ng/mL (area under curve (AUC): 0.791, sensitivity: 75%, specificity: 100%, positive predictive value 100% and negative predictive value 92%) were determined to accurately help the diagnosis of bacterial peritonitis. Conclusion: According to our findings, determination of serum procalcitonin levels seems to provide accurate and rapid diagnosis of ascitic fluid infection.