Differences in the values of procalcitonin in positive gram and gram negative bacteremias in patients with severe sepsis and septic shock

Introduction: Procalcitonin (PCR) is elevated in bacterial infections and discriminates between bacterial infections and of a noninfectious inflammatory response (SIRS). Objective: To determine whether there are differences between the values of PCT for gram negative (GN) and gram positive (GP) in bacteremias secondary to severe sepsis and septic shock and identify their behavior in renal failure (RF). Material and method: Retrospective observational cohort. Bacteremias by GN and GP from 1 January to 31 December 2011. The focus, clinical features, severity scales, hyperlactataemia (lactate >= 3 mmol/l) and average, minimum and maximum concentrations of PCT and CRP (PCR) were estudied. PCT clearance at 48 and 72 h. Quantitative variables analyzed by chi-square and t-Student by continuous or non-parametric tests. Results: 106 bacteremia in 97 patients. Main focus: 32 lung (30.2%). Bacteremia: GN 59.4% and 40.6% GP. Major pathogen: 34.9% E Coli. We show no significant differences in SIRS criteria and severity scales. The hyperlactataemia and hypoxemia were more frequent in the GP in GN (38.5% vs 11.9% p = 0.02 and 48.7% vs 27.1% p = 0.03). PCT values in GN bacteremia were higher without statistical significance. There was statistical significance in the mean serum PCT values (p = 0.05) in patients with chronic renal failure. Conclusions: There was not significant differences in determinations of PCT in GN and GP bacteremia. In patients with chronic renal failure PCT concentrations were higher in episodes of bacteremia GN. The hyperlactatemia was more frequent bacteremia GP.