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Background <p>The serial performance of C-reactive protein (CRP), procalcitonin, and emerging biomarker pancreatic stone protein (PSP) was evaluated for the diagnosis of infection and sepsis in patients admitted to the intensive care unit (ICU).</p> Methods <p>All consecutive adult patients with suspected infection or sepsis upon their admission to the ICUs of three multi-speciality hospitals in the UAE were enrolled. CRP, procalcitonin, and PSP levels were measured at admission and repeated within 24–48&#xa0;h. Patients were categorized into infection vs. non-infection, sepsis vs. non-sepsis groups, and into culture-positive and culture-negative subgroups.</p> Results <p>A total of 272 ICU patients were analyzed. All biomarkers could be used to distinguish infection with CRP (AUROC 0.77; 95% confidence intervals [CI] 0.70–0.83) and procalcitonin (AUROC 0.75; 95% CI 0.68–0.81) showing fair performance. Moreover, serial monitoring at 24–48&#xa0;h improved performance, especially for procalcitonin (<i>p</i> = 0.04). Among patients with infection, PSP levels were higher in culture-positive compared to culture-negative patients, but the difference did not reach statistical significance (median 229 vs. 142 ng/ml, <i>p</i> = 0.05). However, all three biomarkers failed to discriminate sepsis with an AUROC of 0.56 (95% CI 0.49–0.64) for CRP, 0.54 (95% CI 0.46–0.62) for procalcitonin, and 0.58 (95% CI 0.50–0.66) for PSP, respectively. Combining biomarkers improved specificity (93.85%) but with reduced accuracy.</p> Conclusion <p>Despite a significant rise in all biomarkers, procalcitonin has overall better performance for diagnosing infections. None of the biomarkers could differentiate sepsis at admission.</p>

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Comparison of serial pancreatic stone protein, C-reactive protein and procalcitonin for the diagnosis of infection and sepsis in critically Ill patients: a multicentre prospective study

  • 期刊论文

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  • 发表日期：

    2026年5月2日

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  • Vinod Jaiswal,
  • Kalpana Krishnareddy,
  • Sanjay Nihalani,
  • Nimisha Abdul Majeed,
  • Ribin Raj,
  • Alanduru Nirmala Veenanjani,
  • Prashant Nasa

摘要

Background

The serial performance of C-reactive protein (CRP), procalcitonin, and emerging biomarker pancreatic stone protein (PSP) was evaluated for the diagnosis of infection and sepsis in patients admitted to the intensive care unit (ICU).

Methods

All consecutive adult patients with suspected infection or sepsis upon their admission to the ICUs of three multi-speciality hospitals in the UAE were enrolled. CRP, procalcitonin, and PSP levels were measured at admission and repeated within 24–48 h. Patients were categorized into infection vs. non-infection, sepsis vs. non-sepsis groups, and into culture-positive and culture-negative subgroups.

Results

A total of 272 ICU patients were analyzed. All biomarkers could be used to distinguish infection with CRP (AUROC 0.77; 95% confidence intervals [CI] 0.70–0.83) and procalcitonin (AUROC 0.75; 95% CI 0.68–0.81) showing fair performance. Moreover, serial monitoring at 24–48 h improved performance, especially for procalcitonin (p = 0.04). Among patients with infection, PSP levels were higher in culture-positive compared to culture-negative patients, but the difference did not reach statistical significance (median 229 vs. 142 ng/ml, p = 0.05). However, all three biomarkers failed to discriminate sepsis with an AUROC of 0.56 (95% CI 0.49–0.64) for CRP, 0.54 (95% CI 0.46–0.62) for procalcitonin, and 0.58 (95% CI 0.50–0.66) for PSP, respectively. Combining biomarkers improved specificity (93.85%) but with reduced accuracy.

Conclusion

Despite a significant rise in all biomarkers, procalcitonin has overall better performance for diagnosing infections. None of the biomarkers could differentiate sepsis at admission.