Differential diagnosis value of sepsis caused by Gram-negative bacteria and Gram-positive bacteria by D-dimer,PCT and CRP
Objective To investigate the differential diagnostic value of D-dimer(DD),serum procalcitonin(PCT)and C-reactive protein(CRP)in sepsis caused by Gram-negative bacteria(G-bacteria)and Gram positive bacteria(G+bacteria).Methods A total of 296 sepsis patients with positive blood culture admitted in Shaoxing People's Hospital from August 2020 to September 2021 were selected as the research objects.According to the identified pathogenic bacteria,the patients were divided into G-bacteria sepsis group(181 cases)and G+bacteria sepsis group(115 cases);in addition,non-sepsis bloodstream infection patients admitted in the same period were selected as the control,including G-bacteria non-sepsis group(70 cases)and G+bacteria non-sepsis group(43 cases).The levels of DD,PCT and CRP in all subjects were detected.Multivariate Logistic regression analysis was used to screen the most valuable inflammatory markers for the diagnosis of sepsis,and the receiver operating characteristic(ROC)curve was established to evaluate the diagnostic efficacy.Results ROC curve results showed that the area under the curve(AUC)of DD in distinguishing sepsis caused by G-bacteria from non-sepsis caused by G-bacteria was 0.797;the AUC of PCT was 0.699;CRP could not distinguish sepsis caused by G-bacteria from non-sepsis caused by G-bacteria(P>0.05).The AUC of DD in distinguishing sepsis caused by G+bacteria from non-sepsis caused by G+bacteria was 0.697;PCT and CRP could not distinguish sepsis caused by G+bacteria from non-sepsis caused by G+bacteria(P>0.05).The AUC of PCT in distinguishing sepsis caused by G-bacteria from sepsis caused by G+bacteria was 0.618;CRP and DD could not distinguish sepsis caused by G-bacteria from sepsis caused by G+bacteria(P>0.05).Conclusion DD has the highest diagnostic value for sepsis caused by G-bacteria,followed by PCT,and CRP has no diagnostic value;DD has the highest diagnostic value for sepsis caused by G+bacteria,while PCT and CRP has no diagnostic value;PCT has the strongest ability to identify which type of bacteria causes sepsis.